Dahl Mary, Aurit Sarah J, Silberstein Peter T, Gootee Jonathan
Department of Internal Medicine, Division of Hematology/Oncology, Creighton University School of Medicine, Omaha, USA.
Division of Clinical Research and Evaluative Sciences, Creighton University School of Medicine, Omaha, USA.
Cureus. 2021 Oct 31;13(10):e19163. doi: 10.7759/cureus.19163. eCollection 2021 Oct.
Fibrosarcoma (FS) is a rare and malignant tumor that can occur in a variety of anatomic sites. The goal of this study is to use the National Cancer Database (NCDB) to analyze various factors affecting overall survival in FS and to be one of the rare studies to characterize the significance of the primary anatomic sites.
The study cohort included 2,278 patients diagnosed with fibrosarcoma who received surgery from the NCDB. Kaplan-Meier curves, log-rank tests, and a multivariable Cox proportional hazard model were used to analyze the significance of factors affecting overall survival.
The head, face, and neck (HR = 1.44; 95% CI: 1.01-2.05; = 0.046) and thorax anatomical sites (HR = 1.33; 95% CI: 1.02-1.73; = 0.035) had a higher increased risk of death in comparison to the lower limb and hip. Compared to patients with private insurance, patients without insurance (HR = 1.99; 95% CI: 1.22 to 3.25; P = 0.006) and patients with Medicaid (HR = 1.99; 95% CI: 1.37 to 2.90; P < 0.001) had decreased overall survival. Patients associated with a zip code-level median household income ≥ $63,000 had a decreased risk of mortality when compared to lower income groups.
In general, older patients with comorbidities, advanced-stage disease, and larger tumors who did not have private insurance and were from areas associated with lower income levels had poorer overall survival. No significant difference in overall survival was associated with receipt of neoadjuvant chemotherapy or neoadjuvant radiation.
纤维肉瘤（FS）是一种罕见的恶性肿瘤，可发生于多种解剖部位。本研究的目的是利用国家癌症数据库（NCDB）分析影响纤维肉瘤总生存期的各种因素，并成为为数不多的对原发解剖部位的意义进行特征描述的研究之一。
研究队列包括2278例经NCDB确诊为纤维肉瘤并接受手术治疗的患者。采用Kaplan-Meier曲线、对数秩检验和多变量Cox比例风险模型分析影响总生存期的因素的意义。
与下肢和臀部相比，头、面和颈部（HR = 1.44；95% CI：1.01 - 2.05；P = 0.046）和胸部解剖部位（HR = 1.33；95% CI：1.02 - 1.73；P = 0.035）的死亡风险增加更高。与有私人保险的患者相比，没有保险的患者（HR = 1.99；95% CI：1.22至3.25；P = 0.006）和有医疗补助的患者（HR = 1.99；95% CI：1.37至2.90；P < 0.001）的总生存期降低。与邮政编码级别家庭收入中位数≥63,000美元的患者相比，低收入组患者的死亡风险降低。
一般来说，合并症的老年患者、晚期疾病患者和肿瘤较大且没有私人保险且来自低收入水平地区的患者总生存期较差。接受新辅助化疗或新辅助放疗与总生存期无显著差异。
