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伴有远处转移的脂肪肉瘤患者的生存情况及危险因素

Survival and risk factors in patients with liposarcoma with distant metastasis.

作者信息

Lin Feng, Duan Jincai, Lin Yile, Wu Haixiao, Xu Guijun, Guo Xu, Liu Zheng, Xu Yao, Mao Min, Wang Xin, Wang Guowen, Wu Ting, Zhang Chao

机构信息

Department of Bone and Soft Tissue Tumors, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer Tianjin, China.

Clinical Medical College of Tianjin Medical University Tianjin, China.

出版信息

Am J Transl Res. 2020 May 15;12(5):2071-2082. eCollection 2020.

Abstract

BACKGROUND

The distant metastasis in liposarcoma is not thoroughly investigated. Based on a large cohort, we attempted to evaluate the survival in liposarcoma patients with distant metastasis and to reveal the risk factors.

METHODS

The records of liposarcoma patients with or without distant metastasis were extracted from the Surveillance, Epidemiology, and End Result (SEER) database from 2010 to 2016. Survival was calculated by the Kaplan-Meier method. Cox hazard regression was scheduled to investigate prognostic factors for liposarcoma patients with distant metastasis. Risk factors for metastasis were identified by the logistic regression analysis.

RESULTS

A total of 227 liposarcomas with distant metastasis were identified in 4,181 patients. The 5-year survival rate for patients with and without metastasis was 12.1% (95% CI: 5.0%-19.0%) and 75.4% (95% CI: 73.6%-77.2%), respectively. Age ≥60 years (HR=1.73; 95% CI: 1.11-2.69) and surgery (HR=0.26; 95% CI: 0.17-0.41) were independent prognostic factors for patients with metastasis. The annual incidence of distant metastasis was from 3.76% to 7.3%. Liposarcoma in trunk (OR=1.69; 95% CI: 1.02-2.79), myxoid type (OR=2.65; 95% CI: 1.16-6.05), grade III (OR=2.62; 95% CI: 1.17-5.88), grade IV (OR=4.07; 95% CI: 1.84-9.00), T2 stage (OR=2.71; 95% CI: 1.15-6.40), and N1 stage (OR=9.44; 95% CI: 4.63-19.26) were associated with the development of metastasis. Homogeneous and heterogeneous factors were found for patients with different metastatic organs.

CONCLUSIONS

The survival was significantly dismal in liposarcoma patients with distant metastasis. The risk and prognostic factors provide a reference to clinical screening and prevention for distant metastasis in liposarcoma.

摘要

背景

脂肪肉瘤的远处转移尚未得到充分研究。基于一个大型队列,我们试图评估有远处转移的脂肪肉瘤患者的生存率,并揭示危险因素。

方法

从2010年至2016年的监测、流行病学和最终结果(SEER)数据库中提取有或无远处转移的脂肪肉瘤患者的记录。采用Kaplan-Meier方法计算生存率。计划进行Cox风险回归分析以研究有远处转移的脂肪肉瘤患者的预后因素。通过逻辑回归分析确定转移的危险因素。

结果

在4181例患者中,共识别出227例有远处转移的脂肪肉瘤。有转移和无转移患者的5年生存率分别为12.1%(95%CI:5.0%-19.0%)和75.4%(95%CI:73.6%-77.2%)。年龄≥60岁(HR=1.73;95%CI:1.11-2.69)和手术(HR=0.26;95%CI:0.17-0.41)是转移患者的独立预后因素。远处转移的年发病率为3.76%至7.3%。躯干脂肪肉瘤(OR=1.69;95%CI:1.02-2.79)、黏液样型(OR=2.65;95%CI:1.16-6.05)、III级(OR=2.62;95%CI:1.17-5.88)、IV级(OR=4.07;95%CI:1.84-9.00)、T2期(OR=2.71;95%CI:1.15-6.40)和N1期(OR=9.44;95%CI:4.63-19.26)与转移的发生有关。不同转移器官的患者存在同质和异质因素。

结论

有远处转移的脂肪肉瘤患者的生存率明显较差。这些风险和预后因素为脂肪肉瘤远处转移的临床筛查和预防提供了参考。

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