Pulmonary metastasectomy with therapeutic intent for soft-tissue sarcoma.
Pulmonary metastasectomy with therapeutic intent for soft-tissue sarcoma.
复制标题
肺部转移切除术，具有软组织肉瘤的治疗意图。
DOI：
10.1016/j.jtcvs.2017.02.061
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发表时间：
2017-07
期刊：
影响因子：
--
通讯作者：
Jones DR
中科院分区：
文献类型：
--
作者：
Chudgar NP;Brennan MF;Munhoz RR;Bucciarelli PR;Tan KS;D'Angelo SP;Bains MS;Bott M;Huang J;Park BJ;Rusch VW;Adusumilli PS;Tap WD;Singer S;Jones DR
软组织肉瘤是一种异质性疾病，经常包括肺转移的发展。本研究的目的是确定与提高软组织肉瘤患者生存率相关的因素，以帮助指导肺肉瘤切除术的选择。我们回顾了一个前瞻性维护的数据库，确定了1991年9月至2014年6月期间因转移性软组织肉瘤接受肺动脉瘤切除术的803例患者;其中，539例患者接受了760例治疗性肺动脉瘤切除术。临床病理变量和治疗的特点进行了检查。关注的结局是总生存期和无病生存期。使用Kaplan-Meier方法估计生存率，并使用对数秩检验比较变量。使用单变量和多变量考克斯比例风险模型确定与死亡和复发风险相关的因素。中位总生存期为33.2个月（95%置信区间，29.9-37.1），中位无病生存期为6.8个月（95%置信区间，6.0-8.0）。在多变量分析中，平滑肌肉瘤组织学亚型（p=0.007）、原发肿瘤大小≤10 cm（p=0.006）、从原发肿瘤切除到发生转移的时间增加（p<0.001）、孤立性肺转移（p=0.001）和微创切除（p=0.023）与较低的死亡风险相关。无病间隔≥1年（p=0.002）和1次肺转移（p<0.001）与疾病复发风险较低相关。在一项大型单机构研究中，原发肿瘤组织学亚型和大小、肺转移瘤数量、无病间期和微创切除术的选择与接受肺动脉切除术治疗软组织肉瘤患者的生存率增加相关。肉瘤性肺转移瘤患者的生存期较长与肿瘤亚型、大小、转移灶数量和时间以及微创手术相关。组织学、肺转移的数量和手术类型与总生存率相关。
Soft tissue sarcoma is a heterogeneous disease that frequently includes the development of pulmonary metastases. The purpose of this study is to determine factors associated with improved survival among patients with soft tissue sarcoma to help guide selection for pulmonary metastasectomy. We reviewed a prospectively maintained database and identified 803 patients who underwent pulmonary metastasectomy for metastatic soft tissue sarcoma between September 1991 and June 2014; of these, 539 patients undergoing 760 therapeutic-intent pulmonary metastasectomies were included. Clinicopathologic variables and characteristics of treatment were examined. The outcomes of interest were overall survival and disease-free survival. Survival was estimated using the Kaplan-Meier method and compared between variables using the log-rank test. Factors associated with hazard of death and recurrence were identified using univariable and multivariable Cox proportional hazards models. Median overall survival was 33.2 months (95% confidence interval, 29.9–37.1), and median disease-free survival was 6.8 months (95% confidence interval, 6.0–8.0). In multivariable analyses, leiomyosarcoma histologic subtype (p=0.007), primary tumor size ≤10 cm (p=0.006), increasing time from primary tumor resection to development of metastases (p<0.001), solitary lung metastasis (p=0.001), and minimally invasive resection (p=0.023) were associated with lower hazard of death. Disease-free interval ≥1 year (p=0.002), and 1 pulmonary metastasis (p<0.001) were associated with lower hazard of disease recurrence. In a large single-institution study, primary tumor histologic subtype and size, numbers of pulmonary metastases, disease-free interval, and selection for minimally invasive resection are associated with increased survival in patients undergoing pulmonary metastasectomy for soft tissue sarcoma. Tumor subtype and size, number of and time to metastases, and minimally invasive surgery were associated with longer survival in patients with sarcomatous pulmonary metastases. Histology, number of pulmonary metastases, and type of surgery are associated with overall survival.
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影响因子：
4.6
作者：
Blackmon, Shanda H.;Shah, Nipam;Mehran, Reza
通讯作者：
Mehran, Reza
DOI：
10.1111/j.1743-7563.2012.01521.x
发表时间：
2012-09-01
影响因子：
1.9
作者：
Dear, Rachel F.;Kelly, Patrick J.;Tattersall, Martin H. N.
通讯作者：
Tattersall, Martin H. N.
影响因子：
3.8
作者：
Smith, R.;Pak, Y.;Kane, J. M., III
通讯作者：
Kane, J. M., III
影响因子：
--
作者：
Rehders, Alexander;Hosch, Stefan B.;Peiper, Matthias
通讯作者：
Peiper, Matthias
影响因子：
4.6
作者：
Cerfolio, Robert J.;Bryant, Ayesha S.;Minnich, Douglas J.
通讯作者：
Minnich, Douglas J.