Department of Orthopedic Surgery, Mayo Clinic, Phoenix, Arizona, USA.
Department of Orthopedic Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA.
J Surg Oncol. 2024 Sep;130(3):586-593. doi: 10.1002/jso.27782. Epub 2024 Aug 19.
Management of myxofibrosarcoma (MFS) is widely debated, and there is no consensus regarding the effect of adjuvant therapies on local recurrence (LR), distant metastasis (DM), or overall survival (OS). This study aims to determine the effect of adjuvant therapies on the aforementioned outcomes in patients with MFS.
We conducted a systematic review via Medline, PubMed, CINAHL, Cochrane, Embase, and Google Scholar. Therapeutic studies that reported LR, DM, and OS following adjuvant therapies in patients with MFS were included. Statistical analysis and creation of hazard ratios were performed using Revman 5.3 (Cochrane Collaboration).
We identified 301 studies, 10 of which were included in the final analysis. Neither chemotherapy nor radiation affected the rate of LR (p = 0.73 and 0.17, respectively) or OS (p = 0.97 and 0.27, respectively). Chemotherapy was significantly associated with lower rates of DM (p = 0.03); however, there was no association between radiation and DM (p = 0.67).
There is a lack of consensus regarding the effect of neoadjuvant and adjuvant therapies on LR, DM, and OS in patients with MFS. Our systematic review found that radiation and chemotherapy were not significantly associated with OS or LR in patients with MFS. However, we identified a significant association between chemotherapy and lower rates of DM.
黏液纤维肉瘤(MFS)的治疗方式存在广泛争议,对于辅助治疗对局部复发(LR)、远处转移(DM)和总生存(OS)的影响尚无共识。本研究旨在确定辅助治疗对 MFS 患者上述结局的影响。
我们通过 Medline、PubMed、CINAHL、Cochrane、Embase 和 Google Scholar 进行了系统评价。纳入报告了 MFS 患者接受辅助治疗后 LR、DM 和 OS 的治疗研究。使用 Revman 5.3(Cochrane 协作网)进行统计分析和危险比的计算。
我们共检索到 301 项研究,其中 10 项纳入最终分析。化疗和放疗均未影响 LR 率(p=0.73 和 0.17)或 OS 率(p=0.97 和 0.27)。化疗与较低的 DM 率显著相关(p=0.03);而放疗与 DM 无相关性(p=0.67)。
对于新辅助和辅助治疗对 MFS 患者 LR、DM 和 OS 的影响,目前尚无共识。本系统评价发现,放疗和化疗与 MFS 患者的 OS 或 LR 无显著相关性。但我们发现化疗与较低的 DM 率之间存在显著相关性。