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局部黏液样脂肪肉瘤患者围手术期化疗有效吗?

Is perioperative chemotherapy effective in patients with localized myxoid liposarcoma?

作者信息

Masunaga Tomoya, Tsukamoto Shinji, Nitta Yuji, Honoki Kanya, Fujii Hiromasa, Akahane Manabu, Takeda Masayuki, Tanaka Yasuhito, Mavrogenis Andreas F, Errani Costantino, Kawai Akira

机构信息

Department of Orthopaedic Surgery, Nara Medical University, 840, Shijo-cho, Kashihara, Nara 634-8521, Japan.

Department of Diagnostic Pathology, Nara Medical University, 840, Shijo-cho, Kashihara, Nara 634-8521, Japan.

出版信息

Jpn J Clin Oncol. 2024 Mar 9;54(3):297-304. doi: 10.1093/jjco/hyad179.

Abstract

BACKGROUND

This study aimed to compare the local recurrence, distant metastasis and disease-specific survival rates of patients with localized myxoid liposarcoma in the surgery and adjuvant chemotherapy group versus the surgery alone group.

METHODS

A total of 456 patients in the Japanese National Bone and Soft Tissue Tumour Registry database who had localized myxoid liposarcoma and underwent surgery and adjuvant chemotherapy or surgery alone between 2001 and 2019 were included in this retrospective study. The study adjusted for background differences between patients who underwent surgery and adjuvant chemotherapy (n = 228) or surgery alone (n = 228) using propensity score matching.

RESULTS

Univariate analysis showed no significant difference in local recurrence rate between the two groups (5-year local recurrence-free survival: 98.6% [95% confidence interval: 95.9-99.6] vs. 94.0% [95% confidence interval: 89.7-96.6], P = 0.052). Univariate analysis showed no difference in the incidence of distant metastases between the two groups (5-year distant metastasis-free survival: 80.5% [95% confidence interval: 73.9-85.8] vs. 75.1% [95% confidence interval: 67.7-81.2], P = 0.508). Univariate analysis showed no difference in disease-specific survival between the two groups (5-year disease-specific survival: 92.6% [95% confidence interval: 86.1-96.2] vs. 93.2% [95% confidence interval: 87.6-96.4], P = 0.804). In the high-risk group (n = 203) with high-grade tumours and tumour size ≥10 cm, there were no significant differences in the local recurrence, distant metastasis and disease-specific survival rates between the surgery and adjuvant chemotherapy group and the surgery alone group.

CONCLUSION

The effect of adjuvant chemotherapy on localized myxoid liposarcoma appears to be limited.

摘要

背景

本研究旨在比较局部黏液样脂肪肉瘤患者接受手术和辅助化疗与单纯手术的局部复发率、远处转移率和疾病特异性生存率。

方法

本回顾性研究纳入了 2001 年至 2019 年间日本国家骨与软组织肿瘤登记处数据库中接受手术和辅助化疗或单纯手术治疗的局部黏液样脂肪肉瘤患者 456 例。通过倾向评分匹配,对接受手术和辅助化疗(n=228)或单纯手术(n=228)的患者之间的背景差异进行调整。

结果

单因素分析显示两组局部复发率无显著差异(5 年局部无复发生存率:98.6%[95%置信区间:95.9-99.6] vs. 94.0%[95%置信区间:89.7-96.6],P=0.052)。单因素分析显示两组远处转移发生率无差异(5 年远处无转移生存率:80.5%[95%置信区间:73.9-85.8] vs. 75.1%[95%置信区间:67.7-81.2],P=0.508)。单因素分析显示两组疾病特异性生存率无差异(5 年疾病特异性生存率:92.6%[95%置信区间:86.1-96.2] vs. 93.2%[95%置信区间:87.6-96.4],P=0.804)。在高风险组(n=203)中,高级别肿瘤和肿瘤大小≥10cm 的患者中,手术和辅助化疗组与单纯手术组在局部复发、远处转移和疾病特异性生存率方面无显著差异。

结论

辅助化疗对局部黏液样脂肪肉瘤的效果似乎有限。

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