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[脑膜旁或非脑膜旁头颈部横纹肌肉瘤:一项基于倾向评分匹配和生存分析的研究]

[Parameningeal or non-parameningeal head and neck rhabdomyosarcoma: a study based on propensity score matching and survival analysis].

作者信息

Tao Y J, Zhen H N, Guan H, Shen J, Zhang F Q, Liu Z K

机构信息

Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.

出版信息

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Dec 7;57(12):1409-1417. doi: 10.3760/cma.j.cn115330-20220511-00261-1.

Abstract

To compare the prognoses between parameningeal and non-parameningeal head and neck rhabdomyosarcoma based on propensity score matching and to explore the prognostic factors of overall survival in patients with head and neck rhabdomyosarcoma. The medical records of 64 patients with pathologically diagnosed as head and neck rhabdomyosarcoma from January 2016 to May 2020 in Peking Union Medical College Hospital were retrospectively retrieved, including 31 males and 33 females, with an average age of (8.0±8.9) years. Kaplan-Meier method was used to draw and compare survival curves in subgroup analysis according to different histopathological characteristics. Patients were divided into non-parameningeal (27 cases) and parameningeal (37 cases) group based on the location of primary lesion. Patients were further selected using 1∶1 propensity score matching method. The basic clinical data and overall survival were compared before and after matching. Prognostic factors were anlysed using Cox's proportional hazards regression model. In 64 patients with head and neck rhabdomyosarcoma, lower risk stratification, and lower TNM stage indicated higher overall survival (all <0.05). Before matching, patients in parameningeal group presented with higher T stage and IRS (Intergroup Rhabdomyosarcoma Study) staging (all <0.05). There were no significant differences in basic clinical data and 1-, 2-, and 3-year overall survival rates between two groups after matching(>0.05). Tumor size smaller than 5 cm, embryonal histology, negative fusion gene, lower risk stratification, and lower TNM stage were associated with higher overall survival (all <0.05). Among these, tumor size and histology were independent prognostic factors (=2.36, 95%:1.07-5.20, =0.033; =5.54, 95% 1.18-25.95, =0.030). There is no significant difference in overall survival between patients with parameningeal and non-parameningeal rhabdomyosarcomas. Tumor size smaller than 5 cm and embryonal histology are two independent prognostic factors.

摘要

基于倾向得分匹配比较颅底和非颅底头颈部横纹肌肉瘤的预后,并探讨头颈部横纹肌肉瘤患者总生存的预后因素。回顾性检索2016年1月至2020年5月在北京协和医院病理诊断为头颈部横纹肌肉瘤的64例患者的病历,其中男性31例,女性33例,平均年龄(8.0±8.9)岁。采用Kaplan-Meier法绘制并比较根据不同组织病理学特征进行亚组分析的生存曲线。根据原发灶位置将患者分为非颅底组(27例)和颅底组(37例)。采用1∶1倾向得分匹配法进一步选择患者。比较匹配前后的基本临床资料和总生存情况。采用Cox比例风险回归模型分析预后因素。在64例头颈部横纹肌肉瘤患者中,低风险分层和低TNM分期提示总生存率较高(均<0.05)。匹配前,颅底组患者的T分期和IRS(横纹肌肉瘤国际研究组)分期较高(均<0.05)。匹配后两组间基本临床资料及1年、2年和3年总生存率无显著差异(>0.05)。肿瘤大小小于5 cm、胚胎型组织学、融合基因阴性、低风险分层和低TNM分期与较高的总生存率相关(均<0.05)。其中,肿瘤大小和组织学是独立的预后因素(=2.36,95%:1.07-5.20,=0.033;=5.54,95% 1.18-25.95,=0.030)。颅底和非颅底横纹肌肉瘤患者的总生存率无显著差异。肿瘤大小小于5 cm和胚胎型组织学是两个独立的预后因素。

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