滑膜肉瘤亚型的流行病学、发病率和生存率：SEER 数据库分析。
Epidemiology, incidence, and survival of synovial sarcoma subtypes: SEER database analysis.
机构信息
Department of Orthopedics and Traumatology, Ankara Yildirim Beyazit University, Ankara, Turkey.
Department of Orthopedics and Traumatology, Dr Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey.
出版信息
J Orthop Surg (Hong Kong). 2020 Jan-Apr;28(2):2309499020936009. doi: 10.1177/2309499020936009.
BACKGROUND
Synovial sarcoma (SyS) is a rare malignancy that is typically located on the limbs and occurs predominantly in adolescents. A study in a large population for SyS comparing subtypes has not yet been reported.
METHODS
National Cancer Institute's Surveillance, Epidemiology, and End Results database was queried for patients diagnosed with SyS between January 1975 and December 2016. Patients were classified demographically according to gender, age, race/ethnicity, and marital status, and they were also classified by tumors, subtypes, localization, grade, year of diagnosis, laterality, type of treatment, and follow-up results.
RESULTS
A total of 3228 patients were included, with a mean age of 39.3 ± 18.8 (range: 1-94), of which 1521 (47.1%) were females and 1707 (52.9%) were males. According to its subtypes, 47.2% were SyS not otherwise specified, 32.3% were spindle cell, 19.9% were biphasic, and 0.6% were epithelioid type. The overall survival period is 138.0 (95% confidence interval: 113.2-162.8) months. Survival duration was found to be significantly different between groups according to gender (log-rank test; < 0.001), age groups (log-rank test; < 0.001), race (log-rank test; = 0.001), marital status (log-rank test; < 0.001), tumor subtypes (log-rank test; < 0.001), tumor location (log-rank test; < 0.001), tumor laterality (log-rank test; < 0.001), date of diagnosis (log-rank test; = 0.025), tumor grade (log-rank test; < 0.001), historic stage (log-rank test; < 0.001), state of chemotherapy (log-rank test; < 0.001), state of radiotherapy (log-rank test; < 0.001), presence of metastasis (log-rank test; < 0.001), and total number of malignant tumors (log-rank test; < 0.001).
CONCLUSION
Male gender, being colored individual, being over 35 years at the time of diagnosis, epithelioid type, non-head and neck region localization is associated with poor prognosis. While radiotherapy improves survival, benefit of chemotherapy is unclear.
LEVEL OF EVIDENCE
III retrospective analysis.
背景
滑膜肉瘤（SyS）是一种罕见的恶性肿瘤，通常位于四肢，主要发生在青少年中。目前还没有关于比较该肿瘤亚型的大型人群研究。
方法
本研究通过查询美国国立癌症研究所的监测、流行病学和最终结果数据库，纳入了 1975 年 1 月至 2016 年 12 月期间诊断为滑膜肉瘤的患者。患者根据性别、年龄、种族/民族和婚姻状况进行人口统计学分类，并根据肿瘤、亚型、定位、分级、诊断年份、侧别、治疗类型和随访结果进行分类。
结果
共纳入 3228 例患者，平均年龄为 39.3 ± 18.8（范围：1-94）岁，其中 1521 例（47.1%）为女性，1707 例（52.9%）为男性。根据其亚型，47.2%为非特殊型滑膜肉瘤，32.3%为梭形细胞型，19.9%为双相型，0.6%为上皮样型。总的生存周期为 138.0（95%置信区间：113.2-162.8）个月。根据性别（对数秩检验；<0.001）、年龄组（对数秩检验；<0.001）、种族（对数秩检验；=0.001）、婚姻状况（对数秩检验；<0.001）、肿瘤亚型（对数秩检验；<0.001）、肿瘤定位（对数秩检验；<0.001）、肿瘤侧别（对数秩检验；<0.001）、诊断日期（对数秩检验；=0.025）、肿瘤分级（对数秩检验；<0.001）、历史分期（对数秩检验；<0.001）、化疗状态（对数秩检验；<0.001）、放疗状态（对数秩检验；<0.001）、转移存在情况（对数秩检验；<0.001）和恶性肿瘤总数（对数秩检验；<0.001），不同组别间的生存时间存在显著差异。
结论
男性、有色人种、诊断时年龄超过 35 岁、上皮样型、非头颈部定位与预后不良相关。放疗可提高生存率，但化疗的获益尚不清楚。
证据水平
III 级回顾性分析。
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