Rehan N, Bieling P, Winkler P, Helmke K, Maas R, Baldini N, Heise U, Fuchs N, Winkler K
Abt. für Pädiatrische Hämatologie und Onkologie, Universität Hamburg.
Klin Padiatr. 1993 Jul-Aug;205(4):200-9. doi: 10.1055/s-2007-1025228.
In a retrospective analysis on 128 patients from the trials COSS-80, -82, -85 and -86 initial x-ray pictures were evaluated for tumor diameters in three planes and the prognostic meaning on survival was assessed. In a subset of patients (n = 27) the measured values were compared to values obtained by CT-Scan and a good correlation (r = 0.69) was found. Several parameters for tumor size were defined: absolute tumor length (ATL), relative tumor length (RTL, proportion of tumor to the length of the involved bone), absolute tumor volume (ATV, calculated by the ellipsoid formula) and relative tumor volume (RTL, tumor volume referred to the body surface area) and univariate and multivariate survival analysis were performed. Univariate analysis of metastasis free survival (MFS) revealed a high prognostic significance of the ATL, the ATV and the RTV. The RTL in this patient group demonstrated a tendency only toward an inferior prognosis in larger tumors. None of the patients with a ATV < 70 ml (n = 19) and only one of 33 patients with an ATV < 100 ml relapsed. Cox regression analysis was performed including the variables age, sex, site and response (> 90% tumor necrosis) in 84 patients. ATL and RTL do not enter the model, while the response proves its significance as a valid prognostic factor with a p-value of 0.0004. Adding the ATV as the measure of tumor size to the model it enters as the first term (p = 0.0000) followed by the response (p = 0.0002).(ABSTRACT TRUNCATED AT 250 WORDS)
在对来自COSS - 80、- 82、- 85和- 86试验的128例患者进行的回顾性分析中，评估了初始X线片上肿瘤在三个平面的直径，并评估了其对生存的预后意义。在一部分患者（n = 27）中，将测量值与CT扫描获得的值进行比较，发现相关性良好（r = 0.69）。定义了几个肿瘤大小参数：绝对肿瘤长度（ATL）、相对肿瘤长度（RTL，肿瘤长度与受累骨长度的比例）、绝对肿瘤体积（ATV，通过椭球体公式计算）和相对肿瘤体积（RTV，肿瘤体积相对于体表面积），并进行了单变量和多变量生存分析。无转移生存（MFS）的单变量分析显示，ATL、ATV和RTV具有较高的预后意义。该患者组中的RTL仅在较大肿瘤中显示出预后较差的趋势。ATV < 70 ml的患者无一例复发（n = 19），ATV < 100 ml的33例患者中只有1例复发。对84例患者进行了Cox回归分析，纳入了年龄、性别、部位和反应（> 90%肿瘤坏死）等变量。ATL和RTL未进入模型，而反应作为一个有效的预后因素具有显著意义，p值为0.0004。将ATV作为肿瘤大小的指标加入模型后，它作为第一项进入模型（p = 0.0000），其次是反应（p = 0.0002）。（摘要截断于250字）
