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19例非儿童促结缔组织增生性小圆细胞肿瘤患者的临床特征、治疗及预后:一组巴西患者

Clinical Characteristics, Management, and Outcomes of 19 Nonpediatric Patients with Desmoplastic Small Round Cell Tumor: A Cohort of Brazilian Patients.

作者信息

Campos Fernando, Coutinho Daniel L, Silva Maria Letícia G, Lopes Ademar, Nascimento Antônio, Aguiar Júnior Samuel, Nicolau Ulisses R, Formiga Maria Nirvana, D'Almeida Costa Felipe, Mello Celso

机构信息

Department of Medical Oncology, A. C. Camargo Cancer Center, São Paulo, SP, Brazil.

Department of Radiation Oncology, A. C. Camargo Cancer Center, São Paulo, SP, Brazil.

出版信息

Sarcoma. 2020 Oct 28;2020:8713165. doi: 10.1155/2020/8713165. eCollection 2020.

Abstract

Desmoplastic small round cell tumor (DSRCT) is a rare and aggressive mesenchymal malignancy, usually affecting young males. There is no consensus on the best therapeutic approach. We seek to characterize a cohort of nonpediatric patients with DSRCT treated at a large Brazilian cancer center. We performed a retrospective analysis of patients with histologically confirmed DSRCT referred to our institution (2007-2020). Clinical and imaging data were extracted and summarized with descriptive statistics. Survival analyses were conducted by the Kaplan-Meier method and compared with the log-rank test. We included 19 patients with DSRCT, the median age at diagnosis was 26 years (range: 15-41 years), and 68% were male. Ninety percent presented with abdominopelvic masses, and 32% had extra-abdominal metastasis at diagnosis. Eleven patients (58%) underwent surgery, four patients (21%) received whole abdominal adjuvant radiotherapy, and five patients (26%) had hyperthermic intraperitoneal chemotherapy. Median OS was 27 months (interquartile range: 18-51 m). The five-year OS rate was 12%. Our data confirm the aggressiveness of DSRCT despite intense multimodality treatment. Outcomes of patients treated in a reference cancer center in a developing country are similar to cancer centers in developed nations. Multicenter cooperation is urgent to the development of clinical trials and to improve diagnosis and treatment efficacy.

摘要

促纤维组织增生性小圆细胞肿瘤(DSRCT)是一种罕见且侵袭性强的间叶性恶性肿瘤,通常影响年轻男性。对于最佳治疗方法尚无共识。我们试图对在巴西一家大型癌症中心接受治疗的非儿科DSRCT患者队列进行特征描述。我们对转诊至我院(2007 - 2020年)的组织学确诊为DSRCT的患者进行了回顾性分析。提取临床和影像数据并用描述性统计进行总结。采用Kaplan-Meier方法进行生存分析,并与对数秩检验进行比较。我们纳入了19例DSRCT患者,诊断时的中位年龄为26岁(范围:15 - 41岁),68%为男性。90%的患者表现为腹盆腔肿块,32%在诊断时有腹外转移。11例患者(58%)接受了手术,4例患者(21%)接受了全腹辅助放疗,5例患者(26%)进行了热灌注腹腔化疗。中位总生存期为27个月(四分位间距:18 - 51个月)。五年总生存率为12%。我们的数据证实了DSRCT尽管接受了强烈的多模式治疗仍具有侵袭性。在发展中国家的一家参考癌症中心接受治疗的患者的结果与发达国家的癌症中心相似。多中心合作对于开展临床试验以及提高诊断和治疗效果至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a67/7643375/3a003c12f84c/sarcoma2020-8713165.001.jpg

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