Lazarides Alexander L, Burke Zachary D C, Gundavda Manit K, Novak Rostislav, Ghert Michelle, Wilson David A, Rose Peter S, Wong Philip, Griffin Anthony M, Ferguson Peter C, Wunder Jay S, Houdek Matthew T, Tsoi Kim M
Division of Orthopaedic Surgery, Department of Surgery, University of Toronto Musculoskeletal Oncology Unit, Sinai Health System, Toronto, ON M5S 1A8, Canada.
Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON L8V 1C3, Canada.
Cancers (Basel). 2022 Apr 27;14(9):2179. doi: 10.3390/cancers14092179.
Radiation-associated sarcoma of the pelvis and/or sacrum (RASB) is a rare but challenging disease process associated with a poor prognosis. We hypothesized that patients with RASB would have worse surgical and oncologic outcomes than patients diagnosed with primary pelvic or sacral bone sarcomas. This was a retrospective, multi-institution, comparative analysis. We reviewed surgically treated patients from multiple tertiary care centers who were diagnosed with a localized RASB. We also identified a comparison group including all patients diagnosed with a primary localized pelvic or sacral osteosarcoma/spindle cell sarcoma of bone (POPS). There were 35 patients with localized RASB and 73 patients with POPS treated with surgical resection. Patients with RASB were older than those with POPS (57 years vs. 38 years, p < 0.001). Patients with RASB were less likely to receive chemotherapy (71% for RASB vs. 90% for POPS, p = 0.01). Seventeen percent of patients with RASB died in the perioperative period (within 90 days of surgery) as compared to 4% with POPS (p = 0.03). Five-year disease-specific survival (DSS) (31% vs. 54% p = 0.02) was worse for patients with RASB vs. POPS. There was no difference in 5-year local recurrence free survival (LRFS) or metastasis free survival (MFS). RASB and POPS present challenging disease processes with poor oncologic outcomes. Rates of perioperative mortality and 5-year DSS are worse for RASB when compared to POPS.
盆腔和/或骶骨放射性相关肉瘤（RASB）是一种罕见但具有挑战性的疾病过程，预后较差。我们假设，与诊断为原发性盆腔或骶骨骨肉瘤的患者相比，RASB患者的手术和肿瘤学结局更差。这是一项回顾性、多机构的比较分析。我们回顾了多个三级医疗中心接受手术治疗且被诊断为局限性RASB的患者。我们还确定了一个对照组，包括所有被诊断为原发性局限性盆腔或骶骨骨肉瘤/骨梭形细胞肉瘤（POPS）的患者。有35例局限性RASB患者和73例接受手术切除治疗的POPS患者。RASB患者比POPS患者年龄更大（57岁 vs. 38岁，p < 0.001）。RASB患者接受化疗的可能性较小（RASB为71%，POPS为90%，p = 0.01）。17%的RASB患者在围手术期（手术90天内）死亡，而POPS患者为4%（p = 0.03）。RASB患者的5年疾病特异性生存率（DSS）（31% vs. 54%，p = 0.02）低于POPS患者。5年无局部复发生存率（LRFS）或无转移生存率（MFS）没有差异。RASB和POPS都呈现出具有挑战性的疾病过程，肿瘤学结局较差。与POPS相比，RASB的围手术期死亡率和5年DSS更差。
