Department of Oncology & Hematology, IRCCS Humanitas Research Hospital, Rozzano, Italy.
Department of Biomedical Sciences, Humanitas University, Italy.
Cancer Med. 2023 Aug;12(15):16254-16263. doi: 10.1002/cam4.6289. Epub 2023 Jun 27.
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.
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.
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).
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.
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。
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。
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）。
我们的分析证实了在转诊中心随访的青少年和年轻成人肉瘤患者的先前数据。出乎意料的是，诊断延迟与 OS 和 PFS 不良无关。<25 岁的患者由于 SRCT 发生率较高，预后较差。
