Pulmonary metastasectomy for bone and soft tissue sarcoma in Australia: 114 patients from 1978 to 2008
Pulmonary metastasectomy for bone and soft tissue sarcoma in Australia: 114 patients from 1978 to 2008
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DOI：
10.1111/j.1743-7563.2012.01521.x
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发表时间：
2012-09-01
影响因子：
1.9
通讯作者：
Tattersall, Martin H. N.
中科院分区：
文献类型：
--
作者：
Dear, Rachel F.;Kelly, Patrick J.;Tattersall, Martin H. N.
目的：本研究的目的是分析影响总生存率和无复发生存率的预后因素，以帮助选择肺转移瘤切除的患者并告知他们的预后。方法：1978~2008年间，对130例骨肉瘤、软骨肉瘤和尤文氏肉瘤肺转移瘤患者进行了肺转移瘤切除术。分析的结果指标是死亡时间和复发，Cox回归模型分析了预后因素的关联。结果：共分析114例患者。转移瘤切除后5年的总存活率为43%。5年无复发生存率为19%。在多变量分析中，手术切除不完全(P=0.02)与死亡风险增加相关。有微弱证据表明，最大切除转移灶直径=1.8 cm(P=0.07)和无瘤间隔=18个月(P=0.08)与死亡风险增加相关。结论：肺转移瘤切除不完全、最大转移灶直径大、无瘤间隔短是影响肺转移瘤术后总体生存的不良预后因素。围手术期化疗的作用尚不确定。
Aims: The aim of this study is to analyze the prognostic factors for overall and relapse-free survival that may help select patients for pulmonary metastasectomy and inform their prognosis. Methods: From 1978 to 2008 130 patients underwent pulmonary metastasectomy for bone (osteosarcoma, chondrosarcoma and Ewing's sarcoma) and soft tissue sarcomas. Outcome measures analyzed were time to death and relapse and Cox regression models analyzed the association of prognostic factors. Results: In total 114 patients were analyzed. The 5-year post-metastasectomy overall survival rate was 43%. The 5-year relapse-free survival rate was 19%. In the multivariate analysis, an incomplete surgical resection (P = 0.02) was associated with an increased risk of death. There was weak evidence that a diameter of the largest resected metastasis = 1.8 cm (P = 0.07) and a disease-free interval of = 18 months (P = 0.08) were associated with an increased risk of death. Conclusion: Poor prognostic factors for overall survival after a pulmonary metastasectomy are an incomplete surgical resection, a large diameter of the biggest resected metastasis and a short disease-free interval. The role of perioperative chemotherapy is uncertain.