Department of Thoracic Surgery, Okayama University Hospital, Okayama-City, Okayama, Japan.
Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama-City, Okayama, Japan.
Ann Surg Oncol. 2021 Jul;28(7):3884-3890. doi: 10.1245/s10434-020-09272-1. Epub 2020 Nov 24.
Pulmonary metastasectomy could be considered one of the treatment options for disease control in sarcoma patients with pulmonary metastases; however, there is little consensus regarding the suitable criteria for predicting the likely outcomes in these patients. The aim of this study was to establish a prognostic benefit scoring system based on preoperatively examined prognostic factors for sarcoma patients with pulmonary metastases.
This was a single-center, retrospective cohort study conducted in a cohort of 135 sarcoma patients who underwent a first pulmonary metastasectomy at Okayama University Hospital between January 2006 and December 2015. Based on the results of a multivariable logistic regression analysis performed to determine the factors influencing 3-year mortality, a Sarcoma Lung Metastasis Score was created and its correlation with 3-year survival was analyzed.
The results of the multivariate analysis revealed significant differences in the disease-free interval (< 2 years vs. ≥ 2 years; odds ratio (OR) 4.22, 95% confidence interval (CI) 1.67-10.70), maximum tumor diameter (≥ 15 mm vs. < 15 mm; OR 3.86, 95% CI 1.75-8.52), and number of pulmonary metastases (≥ 6 vs. < 6; OR 2.65, 95% CI 1.06-6.620). The Sarcoma Lung Metastasis Score, which was defined as the total score of these three factors, reliably predicted 3-year survival (score: 0, 89.5%; 1, 63.2%; 2, 39.0%; 3, 10.5%).
Our newly proposed simple Sarcoma Lung Metastasis Score appears to be a useful prognostic predictor for sarcoma patients with pulmonary metastases, in that it could be helpful for the selection of appropriate treatments for these patients.
肺转移瘤切除术可被视为控制肉瘤患者肺转移疾病的治疗选择之一；然而，对于哪些患者可能从该治疗中获益，目前尚无共识。本研究旨在建立一个基于肉瘤患者肺转移术前检查预后因素的预后评分系统。
这是一项单中心、回顾性队列研究，纳入了 2006 年 1 月至 2015 年 12 月期间在冈山大学医院接受首次肺转移瘤切除术的 135 例肉瘤患者。基于多变量逻辑回归分析结果，确定影响 3 年死亡率的因素，创建了肉瘤肺转移评分（Sarcoma Lung Metastasis Score，SLMS），并分析其与 3 年生存率的相关性。
多变量分析结果显示，无病间期（<2 年 vs. ≥2 年；比值比（odds ratio，OR）4.22，95%置信区间（confidence interval，CI）1.67-10.70）、最大肿瘤直径（≥15mm vs. <15mm；OR 3.86，95%CI 1.75-8.52）和肺转移灶数目（≥6 个 vs. <6 个；OR 2.65，95%CI 1.06-6.62）存在显著差异。SLMS 是这三个因素的总分，可可靠地预测 3 年生存率（评分：0，89.5%；1，63.2%；2，39.0%；3，10.5%）。
我们新提出的简单 SLMS 似乎是一种有用的肉瘤肺转移患者预后预测指标，因为它有助于为这些患者选择合适的治疗方案。
