An Analysis of Factors Related to Recurrence of Myxofibrosarcoma
An Analysis of Factors Related to Recurrence of Myxofibrosarcoma
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DOI：
10.1093/jjco/hyt119
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发表时间：
2013-11-01
影响因子：
2.4
通讯作者：
Kawai, Akira
中科院分区：
文献类型：
--
作者：
Kikuta, Kazutaka;Kubota, Daisuke;Kawai, Akira
目的：粘液纤维肉瘤是一种临床上以术后局部复发率高为特征的肿瘤。为了改善粘液纤维肉瘤患者的临床结局，必须控制任何术后局部复发。方法：在这项研究中，我们进行了回顾性临床病理分析100例粘液纤维肉瘤，以确定预后不良的相关因素。所有患者均于1999年至2008年在国立癌症中心医院确诊并接受手术。结果：在我院首次就诊时，64例患者患有原发性粘液纤维肉瘤，36例患者在其他机构接受了原发性非计划性切除术。36例患者中，11例在复发前咨询我院，25例在复发后咨询。手术后的组织学阳性切缘在28%的病例中是明显的。估计5年无复发生存率为74.8%。单变量分析显示，在另一家机构（P = 0.0001）和组织学阳性切缘（P = 0.0224）的原发性非计划切除术是局部复发的重要预测因素。当对这两个因素进行多变量分析时，只有在另一个机构进行的原发性非计划性切除术与估计的无复发生存率显著相关（P = 0.0011）。原发性非计划性切除与5年无病生存率显著相关（P = 0.0401）。结论：我们的研究结果表明，在非转诊医院原发性非计划性切除是粘液纤维肉瘤预后不良的最重要的危险因素。准确的诊断和充分的初次手术是提高黏液纤维肉瘤临床疗效的重要因素。
Objective: Myxofibrosarcoma is clinically characterized by a high frequency of local recurrence after surgery. To improve the clinical outcome of patients with myxofibrosarcoma, it is imperative to control any postsurgical local recurrence.Methods: In this study, we performed a retrospective clinicopathologic analysis of 100 consecutive patients with myxofibrosarcoma to identify factors related to poor prognosis. All of the patients had been diagnosed, and had undergone surgery at the National Cancer Center Hospital between 1999 and 2008.Results: At the initial visit to our hospital, 64 patients had primary myxofibrosarcoma, whereas 36 had undergone primary unplanned resection at other facilities. Of the 36 patients, 11 consulted our hospital before recurrence and 25 did so after recurrence. A histologically positive margin after surgery was evident in 28% of the cases overall. The estimated 5-year recurrence-free survival rate was 74.8%. Univariate analysis showed that primary unplanned resection at another facility (P = 0.0001) and a histologically positive margin (P = 0.0224) were significant predictors of local recurrence. When these two factors were subjected to multivariate analysis, only primary unplanned resection at another facility was significantly correlated with the estimated recurrence-free survival rate (P = 0.0011). Primary unplanned resection was also significantly related to the 5-year disease-free survival rate (P = 0.0401).Conclusions: Our findings indicate that primary unplanned resection at a non-referral hospital is the most important risk factor related to poor prognosis of myxofibrosarcoma. Accurate diagnosis and adequate initial surgery are most important factors for improving the clinical outcomes of myxofibrosarcoma.