Department of Orthopedics, Linyi Central Hospital, Yishui, Shandong, People Republic of China.
Department of Orthopedics, The First Affiliated Hospital of Shandong First Medical University, Jinan, Shandong, People Republic of China.
PLoS One. 2020 Jun 3;15(6):e0232466. doi: 10.1371/journal.pone.0232466. eCollection 2020.
Malignant fibrous histiocytoma of the bone (MFH-B) is an extremely rare and aggressive malignancy. The clinicopathological characteristics and prognosis of patients with MFH-B have not been defined. We conducted a retrospective study using the data of all MFH-B patients from the Surveillance, Epidemiology and End Results (SEER) database between 1975 and 2016. Initially, the clinicopathological characteristics were described. The difference in prognosis between patients with MFH-B and those with osteosarcoma was compared using propensity score matching analysis. Then, the features affecting the prognosis of patients with MFH-B were further determined using Cox regression analysis. A total of 318 patients with MFH-B were identified. The median overall survival (mOS) of all 318 patients with MFH-B was 29.0 months. The 1-, 3-, 5-, and 10- year survival rates were 67.4%, 53.6%, 38.7%, and 28.7%, respectively. The multivariate Cox regression analysis showed that older age, distant metastases, and flat bone lesion were independent factors for worse prognosis, whereas surgery was an independent factor for favorable survival, and this intervention could decrease risk of death by 61% (HR = 0.39, 95% CI 0.28-0.54). Apart from this, the prognosis of patients with MFH-B was significantly worse than that of patients with osteosarcoma in both unmatched and matched cohorts. In conclusion, MFH-B is a rare malignant bone cancer, with relatively worse prognosis than osteosarcoma. Older age, distant metastases, flat bone lesion, and surgery were independently associated with prognosis. In order to understand this disease more thoroughly and accurately, more cases with adequate information are required in the future.
骨恶性纤维组织细胞瘤（MFH-B）是一种极其罕见且侵袭性强的恶性肿瘤。MFH-B 患者的临床病理特征和预后尚未明确。我们使用 1975 年至 2016 年间监测、流行病学和最终结果（SEER）数据库中所有 MFH-B 患者的数据进行了回顾性研究。首先，描述了临床病理特征。使用倾向评分匹配分析比较了 MFH-B 患者和骨肉瘤患者的预后差异。然后，使用 Cox 回归分析进一步确定影响 MFH-B 患者预后的特征。共确定了 318 例 MFH-B 患者。所有 318 例 MFH-B 患者的中位总生存期（mOS）为 29.0 个月。1、3、5 和 10 年生存率分别为 67.4%、53.6%、38.7%和 28.7%。多变量 Cox 回归分析表明，年龄较大、远处转移和扁平骨病变是预后不良的独立因素，而手术是生存良好的独立因素，这种干预可使死亡风险降低 61%（HR=0.39，95%CI 0.28-0.54）。除此之外，无论是在未匹配队列还是匹配队列中，MFH-B 患者的预后均明显差于骨肉瘤患者。总之，MFH-B 是一种罕见的恶性骨癌，其预后较骨肉瘤差。年龄较大、远处转移、扁平骨病变和手术与预后独立相关。为了更全面和准确地了解这种疾病，未来需要有更多的病例提供充分的信息。
