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[成人骨肉瘤的延迟诊断:一个需考虑的预后因素]

[Delayed diagnosis of osteosarcoma in adults: a prognostic factor to be considered].

作者信息

Clara-Altamirano M A, García-Ortega D Y, Álvarez-Cano A, Velázquez-Rodríguez S, Lizcano-Suárez A R, Rosas L C, Uribe-Saloma C E, Martínez-Said H, Villavicencio-Valencia V, Cuellar-Hubbe M

机构信息

Departamento De Piel y Partes Blandas, Instituto Nacional de Cancerología (INCan). Ciudad de México. México.

Hospital Christus Muguerza Alta Especialidad. Monterrey, Nuevo León, México.

出版信息

Acta Ortop Mex. 2024 May-Jun;38(3):164-171. doi: 10.35366/115811.

Abstract

INTRODUCTION

different variables have been associated with a worse prognosis of patients with osteosarcoma (OS), highlighting tumor size, location in the axial skeleton and the presence of metastases. The objective of this study is to analyze the prognostic impact of diagnostic delay in osteosarcoma in adults in the Mexican population in a center specialized in sarcomas.

MATERIAL AND METHODS

retrospective cohort study from January 1, 2005, to December 31, 2016, 96 patients over 21 years of age with a diagnosis of osteosarcoma were analyzed.

RESULTS

the median time to diagnosis from the onset of symptoms was six months (range: 2-36). This variable was dichotomized by applying the operator-dependent curve (ROC) analysis and we determined a cut-off value greater than five months, with an area under the curve (AUC) = 0.93 [95% CI 0.86-0.97], sensitivity 93.2% and specificity 94.6%.

CONCLUSION

time until diagnosis is a critical factor in the survival of adult patients with osteosarcoma, highlighting its influence on disease progression and the appearance of metastasis. The correlation between diagnostic delay and an unfavorable prognosis reinforces the need for rapid and efficient evaluation in suspected cases of osteosarcoma.

摘要

引言

不同变量与骨肉瘤(OS)患者的较差预后相关,其中突出的有肿瘤大小、轴向骨骼位置以及转移灶的存在。本研究的目的是分析在一家肉瘤专科医院中,诊断延迟对墨西哥成年骨肉瘤患者预后的影响。

材料与方法

回顾性队列研究,分析了2005年1月1日至2016年12月31日期间96例年龄超过21岁且诊断为骨肉瘤的患者。

结果

从症状出现到诊断的中位时间为6个月(范围:2 - 36个月)。通过应用依赖操作者的曲线(ROC)分析将该变量进行二分法分析,我们确定了一个大于5个月的临界值,曲线下面积(AUC)= 0.93 [95%可信区间0.86 - 0.97],敏感性93.2%,特异性94.6%。

结论

诊断所需时间是成年骨肉瘤患者生存的关键因素,突出了其对疾病进展和转移出现的影响。诊断延迟与不良预后之间的相关性强化了在骨肉瘤疑似病例中进行快速有效评估的必要性。

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