Good Prognosis of Localized Osteosarcoma in Young Patients Treated With Limb-Salvage Surgery and Chemotherapy
Good Prognosis of Localized Osteosarcoma in Young Patients Treated With Limb-Salvage Surgery and Chemotherapy
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DOI：
10.1002/pbc.23172
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发表时间：
2011-09-01
影响因子：
3.2
通讯作者：
Kovacs, Gabor
中科院分区：
文献类型：
--
作者：
Hegyi, Marta;Semsei, Agnes F.;Kovacs, Gabor
背景资料。这份报告的目的是评估患有骨肉瘤的儿童和青少年的长期结果和预后因素。我们国家肿瘤学中心对一大群骨肉瘤患者进行了分析。程序。为了评价手术和多药化疗治疗骨肉瘤的疗效，我们回顾了1988年至2006年在布达佩斯儿科二科治疗的122例骨肉瘤患者(男性65例，女性57例，平均年龄13.8±3.6岁)。分析人口学参数、肿瘤相关变量和治疗相关变量、反应、总生存期(OS)和无事件生存期(EFS)。结果。5年OS为68%，5年EFS为62%。无转移者OS为79%，早期转移者为17%。截肢患者(n=30)与保肢手术患者(n=82)的存活率差异无统计学意义，但未行根治性手术的患者全部死亡。性别和组织学分型对预后无意义。四肢局部肿瘤患者的生存率高于中枢性骨骼肿瘤患者(P=0.013)。对新辅助化疗的组织学反应差(肿瘤细胞存活率为10%)与生存率下降有关(P=0.018)。14岁以下患者的EFS好于14岁以上患者(P=0.008)。结论。我们的结果表明，接受保肢手术和化疗的四肢局限性骨肉瘤的年轻患者有很好的存活率。儿科血癌杂志2011；57：415-422。(C)2011年Wiley-Liss，Inc.
Background. The objective of this report was to estimate long-term outcome and prognostic factors in children and adolescents with osteosarcoma. A large group of osteosarcoma patients were analyzed at our national oncology center. Procedure. To evaluate the efficacy of surgery and multiagent chemotherapy for treating osteosarcoma, we reviewed 122 cases (65 male, 57 female, mean age 13.8 +/- 3.6 years) treated at the Second Department of Pediatrics in Budapest between 1988 and 2006. Demographic parameters, tumor-related and treatment-related variables, response, overall survival (OS) and event-free survival (EFS) were analyzed. Results. The 5-year OS was 68% and 5-year EFS was 62%. OS of patients without metastasis was 79%, while OS with early metastasis was 17%. Survival of patients with amputation (n = 30) was not significantly different from patients with limb-salvage surgery (n = 82), but all patients without radical surgery died. Gender and histological classification had no prognostic significance. Patients with localized tumors in extremities had increased survival compared to patients with axial skeleton tumors (P = 0.013). Poor histological response to neoadjuvant chemotherapy (rate of survivor tumor cells >10%) was associated with decreased survival (P = 0.018). Patients under 14 years had better EFS than patients over 14 years (P = 0.008). Conclusions. Our results demonstrate that younger patients with localized osteosarcoma of the extremities who receive limb-salvage surgery and chemotherapy have an excellent survival. Pediatr Blood Cancer 2011; 57: 415-422. (C) 2011 Wiley-Liss, Inc.