Ryu Jae Hong, Rahman Juma, Deo Shaneel, Flint Michael
Department of Orthopaedic Surgery, Middlemore Hospital, Counties Manukau Health, Auckland, New Zealand.
Research and Evaluation Office, Counties Manukau Health, Auckland, New Zealand.
J Surg Oncol. 2023 Jun;127(7):1174-1186. doi: 10.1002/jso.27237. Epub 2023 Mar 20.
Few studies have investigated the effects of time to treatment initiation (TTI) for soft tissue sarcomas (STS). Our objective was to investigate the risk factors for prolonged TTI and the effects of prolonged TTI on local recurrence free survival (LRFS), distant metastasis free survival (DMFS), and disease specific survival (DSS).
Patients diagnosed with high-grade STS of the extremities and trunk from 2011 to 2020 were included. TTI was grouped into two groups (treatment provided in less than vs. more than or equal to 30 days). Two-year and 5-year survival probabilities were calculated for LRFS, DMFS, and DSS. Cox regression and Kruskal-Wallis tests in univariate analysis were conducted to find risk factors affecting TTI and the survival outcomes.
In the univariate analysis, diagnosis in the later 5-year period of the study, tumor size, and treatment modality were associated with prolonged TTI. TTI ≥30 days was associated with higher DMFS but no association was found with LRFS or DSS. Tumor size, surgical margins, and provision of surgery were associated with DSS.
Despite the delay in treatment for STS patients caused by the COVID-19 pandemic, our study showed TTI of more than 30 days does not negatively impact patients.
很少有研究调查软组织肉瘤(STS)治疗开始时间(TTI)的影响。我们的目的是调查TTI延长的危险因素以及TTI延长对无局部复发生存期(LRFS)、无远处转移生存期(DMFS)和疾病特异性生存期(DSS)的影响。
纳入2011年至2020年诊断为四肢和躯干高级别STS的患者。TTI分为两组(30天内与30天及以上接受治疗)。计算LRFS、DMFS和DSS的2年和5年生存概率。进行单因素分析中的Cox回归和Kruskal-Wallis检验,以找出影响TTI和生存结果的危险因素。
在单因素分析中,研究后5年的诊断、肿瘤大小和治疗方式与TTI延长有关。TTI≥30天与较高的DMFS相关,但与LRFS或DSS无关。肿瘤大小、手术切缘和手术的实施与DSS有关。
尽管COVID-19大流行导致STS患者治疗延迟,但我们的研究表明,30天以上的TTI对患者没有负面影响。