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脊柱软骨母细胞瘤的临床病理及预后特征:来自单一机构和27项研究的个体患者数据汇总分析

Clinicopathological and Prognostic Characteristics in Spinal Chondroblastomas: A Pooled Analysis of Individual Patient Data From a Single Institute and 27 Studies.

作者信息

Zheng Bo-Wen, Huang Wei, Liu Fu-Sheng, Zhang Tao-Lan, Wang Xiao-Bin, Li Jing, Lv Guo-Hua, Yan Yi-Guo, Zou Ming-Xiang

机构信息

Health Management Center, The First Affiliated Hospital, University of South China, Hengyang, China.

Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha, China.

出版信息

Global Spine J. 2023 Apr;13(3):713-723. doi: 10.1177/21925682211005732. Epub 2021 Apr 26.

Abstract

STUDY DESIGN

Retrospective pooled analysis of individual patient data.

OBJECTIVES

Spinal chondroblastoma (CB) is a very rare pathology and its clinicopathological and prognostic features remain unclear. Here, we sought to characterize the clinicopathological data of a large spinal CB cohort and determine factors affecting the local recurrence-free survival (LRFS) and overall survival (OS) of patients.

METHODS

Electronic searches using Medline, Embase, Google Scholar and Wanfang databases were performed to identify eligible studies per predefined criteria. A retrospective review was also conducted to include additional patients at our center.

RESULTS

Twenty-seven studies from the literature and 8 patients from our local institute were identified, yielding a total of 61 patients for analysis. Overall, there were no differences in clinicopathological characteristics between the local and literature cohorts, except for absence or presence of spinal canal invasion by tumor on imagings and chicken-wire calcification in tumor tissues. Univariate Kaplan-Meier analysis revealed that previous treatment, preoperative or postoperative neurological deficits, type of tumor resection, secondary aneurysmal bone cyst (ABC), chicken-wire calcification and radiotherapy correlated closely with LRFS, though only type of tumor resection, chicken-wire calcification and radiotherapy were predictive of outcome based on multivariate Cox analysis. Analyzing OS, we found that a history of preoperative treatment, concurrent ABC, chicken-wire calcification, type of tumor resection and adjuvant radiotherapy had a significant association with survival, whereas only type of tumor resection remained statistically significant after adjusting for other covariables.

CONCLUSION

These data may be helpful in prognostic risk stratification and individualized therapy decision making for patients.

摘要

研究设计

对个体患者数据进行回顾性汇总分析。

目的

脊柱软骨母细胞瘤(CB)是一种非常罕见的病理类型,其临床病理和预后特征仍不明确。在此,我们试图描述一个大型脊柱CB队列的临床病理数据,并确定影响患者局部无复发生存期(LRFS)和总生存期(OS)的因素。

方法

使用Medline、Embase、谷歌学术和万方数据库进行电子检索,以根据预定义标准识别符合条件的研究。还进行了回顾性研究,纳入我们中心的其他患者。

结果

从文献中确定了27项研究,从我们当地机构确定了8例患者,共61例患者进行分析。总体而言,本地队列和文献队列的临床病理特征没有差异,除了影像学上肿瘤是否侵犯椎管以及肿瘤组织中是否存在筛孔状钙化。单因素Kaplan-Meier分析显示,既往治疗、术前或术后神经功能缺损、肿瘤切除类型、继发性骨囊肿(ABC)、筛孔状钙化和放疗与LRFS密切相关,尽管基于多因素Cox分析,只有肿瘤切除类型、筛孔状钙化和放疗可预测预后。分析OS时,我们发现术前治疗史、合并ABC、筛孔状钙化、肿瘤切除类型和辅助放疗与生存有显著关联,而在调整其他协变量后,只有肿瘤切除类型仍具有统计学意义。

结论

这些数据可能有助于患者的预后风险分层和个体化治疗决策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd8c/10240578/b9d6cf319ee3/10.1177_21925682211005732-fig1.jpg

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