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颌骨原发性骨肉瘤根治术后辅助治疗的临床意义。

Clinical significance of adjuvant therapy after radical surgery for primary osteosarcoma of the jaws.

机构信息

Department of Medical Oncology, Fengxian District Central Hospital, 201499, Shanghai, China.

Department of Oncology, Huashan Hospital, Fudan University, 200040, Shanghai, China.

出版信息

Wien Klin Wochenschr. 2023 Sep;135(17-18):488-495. doi: 10.1007/s00508-023-02228-x. Epub 2023 Jun 12.

Abstract

BACKGROUND

Osteosarcoma of the jaw is one of the rare malignancies and the role of postoperative adjuvant therapy is unclear. This study explored the efficacy of adjuvant therapy after radical surgery for primary osteosarcoma of the jaw.

METHODS

The data were retrospectively analyzed from May 2012 to June 2021. The recurrence rate, disease-free survival (DFS) and 5‑year overall survival (OS) rate were calculated by Kaplan-Meier method. Intergroup rates were examined by chi-square test.

RESULTS

125 post-radical surgery patients were included. The median follow-up time was 66 months. Forty five cases suffered recurrence. The recurrence rate was 36.0%, and the 5‑year OS rate was 68.8%. In the adjuvant treatment group, twenty eight of 99 patients experienced disease progression. In the surgical treatment alone group, seventeen of 26 patients experienced disease progression. The recurrence rates in the two groups were 28.3 and 65.4%, respectively (χ = 12.303, p < 0.001). The 5‑year OS rate was 75.8 and 42.3%, respectively (χ = 10.734, p = 0.001). The median DFS of the relapse patients was 15.1 months (95% CI:13.00-17.20 months), and the 5‑year OS rate was 40.0%. Among them, 28 patients received adjuvant therapy while 17 received surgical treatment alone. The median DFS was 15.7 and 11.5 months, respectively, p = 0.024. The median OS was 69.6 months (95% CI 55.69 ~ 83.51 months) and 62.4 months (95% CI 49.06 ~ 75.74 months), respectively(p = 0.034).

CONCLUSION

Adjuvant therapy is one of the effective measures to reduce the relapse rate and improve OS after radical surgery for primary osteosarcoma of the jaw.

摘要

背景

颌骨骨肉瘤是一种罕见的恶性肿瘤,术后辅助治疗的作用尚不清楚。本研究探讨了根治性手术后原发性颌骨骨肉瘤的辅助治疗效果。

方法

回顾性分析 2012 年 5 月至 2021 年 6 月的资料。采用 Kaplan-Meier 法计算复发率、无病生存率(DFS)和 5 年总生存率(OS)。组间率的比较采用卡方检验。

结果

共纳入 125 例根治性手术后患者,中位随访时间为 66 个月。45 例患者复发,复发率为 36.0%,5 年 OS 率为 68.8%。在辅助治疗组,99 例患者中有 28 例发生疾病进展。在单纯手术治疗组,26 例患者中有 17 例发生疾病进展。两组的复发率分别为 28.3%和 65.4%(χ²=12.303,p<0.001)。5 年 OS 率分别为 75.8%和 42.3%(χ²=10.734,p=0.001)。复发患者的中位 DFS 为 15.1 个月(95%CI:13.00-17.20 个月),5 年 OS 率为 40.0%。其中 28 例患者接受辅助治疗,17 例患者接受单纯手术治疗。中位 DFS 分别为 15.7 个月和 11.5 个月,p=0.024。中位 OS 分别为 69.6 个月(95%CI:55.6983.51 个月)和 62.4 个月(95%CI:49.0675.74 个月),p=0.034。

结论

辅助治疗是降低原发性颌骨骨肉瘤根治性手术后复发率、提高 OS 的有效措施之一。

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