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2005 年至 2010 年间肉瘤患者的总体生存率和净生存率:来自法国癌症登记处网络(FRANCIM)的结果。

Overall and net survival of patients with sarcoma between 2005 and 2010: Results from the French Network of Cancer Registries (FRANCIM).

机构信息

Epicene Team, Bordeaux Population Health Research Center, French National Institute of Health and Medical Research (INSERM) UMR 1219, University of Bordeaux, Bordeaux, France.

Gironde Cancer Registry, INSERM CIC-1401, University of Bordeaux, Bordeaux, France.

出版信息

Cancer. 2022 Jul 1;128(13):2483-2492. doi: 10.1002/cncr.34217. Epub 2022 Apr 6.

Abstract

BACKGROUND

Sarcomas are rare, heterogeneous, ubiquitously localized malignancies with many histologic subtypes and genomic patterns. The survival of patients with sarcoma has rarely been described based on this heterogeneity; therefore, the authors' objective was to estimate survival outcomes in patients who had sarcomas using the 2020 version of the World Health Organization classification of soft tissue and bone tumors.

METHODS

Patients older than 15 years who had incident sarcoma diagnosed between 2005 and 2010 were extracted from 14 French population-based cancer registries covering 18% of the French metropolitan population. Vital status for each patient was actively followed up to June 30, 2013. Net survival (NS) was estimated using the unbiased Pohar-Perme method.

RESULTS

Overall, 4202 patients were included. NS declined with increasing age at diagnosis. According to topographic groups, large 5-year NS disparities were observed, ranging from 47% among women with gynecologic sarcomas to 89% among patients with skin sarcomas. Patients with soft tissue, bone, and gastrointestinal sarcomas had 5-year NS rates of 53%, 61%, and 70%, respectively. Similar heterogeneity was observed according to histologic subtypes, with 5-year NS ranging from 19% for patients with angiosarcomas to 96% for patients with dermatofibrosarcomas. Patients with sarcoma who displayed missense mutations had a better 5-year NS (74%); those with MDM2-amplified sarcomas had the worst NS (45%).

CONCLUSIONS

NS rates in patients with sarcoma are presented here for the first time based on the 2020 World Health Organization classification applied to population-based registry data. Large prognostic heterogeneity was observed based on age, topographic and histologic groups, and genomic alteration profiles, constituting a benchmark for future studies and clinical trials.

摘要

背景

肉瘤是罕见的、异质性的、普遍存在的恶性肿瘤,具有多种组织学亚型和基因组模式。肉瘤患者的生存情况很少根据这种异质性来描述;因此,作者的目的是使用 2020 年版世界卫生组织软组织和骨肿瘤分类来估计患有肉瘤的患者的生存结果。

方法

从覆盖法国大都市人口 18%的 14 个法国基于人群的癌症登记处中提取了 2005 年至 2010 年间诊断为偶发性肉瘤的年龄大于 15 岁的患者。每位患者的生存状态都通过主动随访至 2013 年 6 月 30 日。使用无偏 Pohar-Perme 法估计净生存率(NS)。

结果

总体而言,共纳入了 4202 名患者。NS 随诊断时年龄的增加而降低。根据解剖部位分组,观察到 5 年 NS 存在较大差异,范围从妇科肉瘤女性患者的 47%到皮肤肉瘤患者的 89%。软组织、骨和胃肠道肉瘤患者的 5 年 NS 率分别为 53%、61%和 70%。根据组织学亚型也观察到类似的异质性,5 年 NS 范围从血管肉瘤患者的 19%到纤维肉瘤患者的 96%。显示错义突变的肉瘤患者有更好的 5 年 NS(74%);MDM2 扩增肉瘤患者的 NS 最差(45%)。

结论

本文首次根据应用于基于人群的登记数据的 2020 年世界卫生组织分类报告了肉瘤患者的 NS 率。根据年龄、解剖部位和组织学组以及基因组改变谱观察到了很大的预后异质性,为未来的研究和临床试验提供了基准。

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