青少年和年轻成人（AYA）肉瘤的多学科管理：一个成人高容量癌症中心的成功努力。

Multidisciplinary management of adolescents and young adults (AYA) sarcoma: A successful effort of an adult high-volume cancer center.

机构信息

Department of Oncology & Hematology, IRCCS Humanitas Research Hospital, Rozzano, Italy.

Department of Biomedical Sciences, Humanitas University, Italy.

出版信息

Cancer Med. 2023 Aug;12(15):16254-16263. doi: 10.1002/cam4.6289. Epub 2023 Jun 27.

DOI:10.1002/cam4.6289

PMID:37366268

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10469812/

Abstract

INTRODUCTION

The aim of this retrospective study was to investigate the clinicopathological characteristics of AYA sarcomas and their clinical outcomes at a high-volume single center.

METHODS

Demographic, clinicopathological data on the diagnosis, treatment and follow-up of all sarcoma patients aged 16-39 years (ys) observed at our Institute between January 2010 and December 2021 were retrospectively collected, including diagnostic (TTD) and treatment delay(TTT), clinical outcomes (OS and PFS), and late-treatment effects.

RESULTS

We identified 228 AYA patients, median age 30 years, 29% ≤ 25 years, 57% males, 88% soft tissue sarcomas (STS), and 12% bone sarcomas (BS). Among STSs, 13% were small round cell tumors (SRCT), 52% intermediate-high-grade, 24% low-grade STSs. Among BS, 32% were high-grade. Median TTD and TTT were 120 (0-8255) and 7 days (0-83), respectively. Surgery was performed in 83%, radiotherapy in 29%, and systemic therapy in 27%. Median follow-up was 72.9 months(1.6-145), 5-year and 10-year OS were 78.5% and 62%, respectively. Kaplan-Meyer analysis showed a significantly better 5-year OS and PFS for patients with >92 days of TTD (OS 85.7% vs. 66.7%, p = 0.001, PFS 50.2% vs. 24.9%, p = 0.009). According to age (≤25 years vs. > 25 years), 5-year OS was 69.8% versus 82.2%, respectively (p = 0.047).

CONCLUSION

Our analysis confirmed previous data on sarcoma AYA patients followed in a referral center. Unexpectedly, diagnostic delay was not associated with poor OS and PFS. Patients <25 years showed a poorer prognosis due to the higher incidence of SRCT.

摘要

简介

本回顾性研究旨在调查高容量单一中心的青少年和年轻成人（AYA）肉瘤的临床病理特征及其临床结局。

方法

收集 2010 年 1 月至 2021 年 12 月期间我院所有年龄在 16-39 岁（岁）的肉瘤患者的诊断、治疗和随访的人口统计学、临床病理数据，包括诊断（TTD）和治疗延迟（TTT）、临床结局（OS 和 PFS）和晚期治疗效果。

结果

共纳入 228 例 AYA 患者，中位年龄 30 岁，29%≤25 岁，57%为男性，88%为软组织肉瘤（STS），12%为骨肉瘤（BS）。在 STS 中，13%为小圆细胞肿瘤（SRCT），52%为中高级别，24%为低级别 STS。BS 中，32%为高级别。中位 TTD 和 TTT 分别为 120（0-8255）和 7 天（0-83）。83%的患者行手术治疗，29%的患者行放疗，27%的患者行全身治疗。中位随访时间为 72.9 个月（1.6-145），5 年和 10 年 OS 分别为 78.5%和 62%。Kaplan-Meier 分析显示 TTD 时间>92 天的患者 5 年 OS 和 PFS 显著改善（OS 85.7% vs. 66.7%，p=0.001，PFS 50.2% vs. 24.9%，p=0.009）。根据年龄（≤25 岁与>25 岁），5 年 OS 分别为 69.8%和 82.2%（p=0.047）。