Zhu Dongsheng, Zheng Wen, Zhu Zhitao, Chen Feng, Wang Xiaodong
Department of Orthopedics, Children's Hospital of Soochow University, Suzhou, China.
Department of Pediatric Orthopedics, The First People's Hospital of Lianyungang, Lianyungang, China.
Transl Pediatr. 2024 Jul 31;13(7):1179-1189. doi: 10.21037/tp-24-59. Epub 2024 Jul 29.
Roughly 5% to 10% of soft tissue sarcomas fall under the category of synovial sarcomas (SSs), a rare and malignant tumor originating from soft tissues with unclear differentiation, primarily affecting teenagers and young adults. The goal of this study was to assess the latest survival rates for SS of children and the risk factors affecting survival using the Surveillance, Epidemiology and End Results (SEER) database.
Age, sex, race, SEER stage, surgery, radiation, chemotherapy, laterality, site of SS, and survival time were collected in the SEER database for survival and prognostic factor analysis. The overall survival curves and cancer special survival were obtained by Kaplan-Meier according to different factors. A multivariate Cox regression model and a predictive nomogram have also been constructed.
A total of 130 patients were enrolled in the study. In the overall survival analysis, age (P=0.01), male (P=0.04), no surgery (P<0.01), chemotherapy (P<0.01), primary tumor site in soft tissue (P=0.02), and in distant of SEER stage (P<0.01) were associated with a worse prognosis in children with SS. Multivariate analysis showed that chemotherapy and in distant of SEER stage were independent indicators of unfavorable prognosis. A similar result was released in the specialized cancer survival analysis. A nomogram was used to predict the prognosis of SS in children and a calibration curve was used to validate the nomogram prediction against the actual observed survival outcomes.
In summary, chemotherapy, and worse SEER stage were associated with poorer overall and cancer special survivals. Nomogram was able to predict the probability of 1-, 5- and 10-year overall survivals and showed good consistency with the actual observed outcomes.
大约5%至10%的软组织肉瘤属于滑膜肉瘤（SS），这是一种罕见的恶性肿瘤，起源于分化不明的软组织，主要影响青少年和青年。本研究的目的是使用监测、流行病学和最终结果（SEER）数据库评估儿童滑膜肉瘤的最新生存率以及影响生存的危险因素。
在SEER数据库中收集年龄、性别、种族、SEER分期、手术、放疗、化疗、肿瘤部位、滑膜肉瘤的部位和生存时间，用于生存和预后因素分析。根据不同因素，通过Kaplan-Meier法获得总生存曲线和癌症特异性生存曲线。还构建了多变量Cox回归模型和预测列线图。
本研究共纳入130例患者。在总生存分析中，年龄（P=0.01）、男性（P=0.04）、未接受手术（P<0.01）、化疗（P<0.01）、软组织原发性肿瘤部位（P=0.02）以及SEER分期远处转移（P<0.01）与滑膜肉瘤患儿预后较差相关。多变量分析显示，化疗和SEER分期远处转移是不良预后的独立指标。在癌症特异性生存分析中也得出了类似结果。使用列线图预测儿童滑膜肉瘤的预后，并使用校准曲线根据实际观察到的生存结果验证列线图预测。
总之，化疗和较差的SEER分期与总体和癌症特异性生存率较低相关。列线图能够预测1年、5年和10年总生存率的概率，并且与实际观察结果显示出良好的一致性。
