Why do patients with low-grade soft tissue sarcoma die?
Why do patients with low-grade soft tissue sarcoma die?
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DOI：
10.1245/s10434-008-0163-0
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发表时间：
2008-12
影响因子：
3.7
通讯作者：
Brennan MF
中科院分区：
文献类型：
--
作者：
Canter RJ;Qin LX;Ferrone CR;Maki RG;Singer S;Brennan MF
在少数死于疾病的低级别软组织肉瘤（STS）患者中，肉瘤特异性死亡的失败模式和机制的特征很差。在1982年至2006年期间，2041例年龄≥ 16岁的低级别STS患者在所有研究中心接受了根治性治疗，并在一家机构进行了前瞻性随访。在2041例患者的队列中，181例（9%）死于疾病（DOD）。总体而言，105例患者（58%）死于局部复发性疾病（DOLR），59例（32%）死于远处疾病（DODR）。在17例患者（9%）中，无法证实肉瘤相关死亡的机制。DOD发生的中位时间为62个月，而整个队列的中位疾病特异性生存期尚未达到。中位随访时间为66个月（范围2 - 431）。在多变量分析中，DOD与部位、大小和小于R 0切除相关。对于DOLR，部位、大小、阳性边缘、脂肪肉瘤组织学和局部复发（根据定义）是重要因素。对于DODR，部位、组织学和阳性切缘不是显著因素，而大小和局部复发是显著因素。在DOLR中，80%为腹膜后，68%为脂肪肉瘤，仅2%为四肢。相反，在DODR中，四肢（47%）和躯干（18%）是最常见的部位，但组织学更多变（脂肪肉瘤35%，MFH 20%，纤维肉瘤12%，皮肤外粘液样软骨肉瘤10%）。DOLR（27%）和DODR（25%）的高级别复发率相当。在低级别STS患者中，DOD发生在约9%的患者中。非肢体部位、较大肿瘤和小于R 0切除是DOD最重要的危险因素，原发肿瘤部位预测不同的复发和死亡模式。
The patterns of failure and mechanisms of sarcoma-specific death are poorly characterized among the minority of patients with low grade soft tissue sarcoma (STS) who succumb to disease. Between 1982 and 2006, 2041 patients age ≥ 16 with low grade STS of all sites were treated with curative intent and prospectively followed at a single institution. Among this cohort of 2041 patients, 181 (9%) died from disease (DOD). Overall, 105 patients (58%) died from locally recurrent disease (DOLR), and 59 (32%) died from distant disease (DODR). In 17 patients (9%), the mechanism of sarcoma-related death could not be verified. DOD occurred at a median of 62 months, while median disease-specific survival for the entire cohort was not reached. Median follow-up was 66 months (range 2 – 431). On multivariate analysis, DOD was associated with site, size, and less than R0 resection. For DOLR, site, size, positive margins, liposarcoma histology, and local recurrence (by definition) were significant factors. For DODR, site, histology, and positive margins were not significant factors, while size and local recurrence were. Of DOLR, 80% were retroperitoneal, 68% were liposarcoma, and only 2% were extremity. Conversely, of DODR, extremity (47%) and trunk (18%) were the most common sites, but histology was more variable (liposarcoma 35%, MFH 20%, fibrosarcoma 12%, extraskeletal myxoid chondrosarcoma 10%). High grade recurrence rates were comparable among DOLR (27%) and DODR (25%). Among patients with low grade STS, DOD occurs in approximately 9% of patients. Non-extremity site, larger size, and less than R0 resection are the most important risk factors for DOD, and distinct patterns of recurrence and death are predicted by primary tumor site.
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影响因子：
1.9
作者：
PRENTICE, RL;KALBFLEISCH, JD;BRESLOW, NE
通讯作者：
BRESLOW, NE
影响因子：
45.3
作者：
GAYNOR, JJ;TAN, CC;BRENNAN, MF
通讯作者：
BRENNAN, MF
影响因子：
3.7
作者：
Koea, JB;Leung, D;Brennan, MF
通讯作者：
Brennan, MF
影响因子：
9
作者：
SINGER, S;CORSON, JM;EBERLEIN, TJ
通讯作者：
EBERLEIN, TJ
影响因子：
4.4
作者：
Dunn, GP;Ikeda, H;Schreiber, RD
通讯作者：
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