Survival analysis of elderly patients with osteosarcoma
Survival analysis of elderly patients with osteosarcoma
复制标题
DOI：
10.1007/s00264-019-04332-y
复制
发表时间：
2019-07-01
影响因子：
2.7
通讯作者：
Yoshikawa, Hideki
中科院分区：
文献类型：
--
作者：
Imura, Yoshinori;Takenaka, Satoshi;Yoshikawa, Hideki
背景很少有研究描述老年骨肉瘤患者的特点和预后因素。我们回顾性调查了> 40岁骨肉瘤患者的临床病理特征和预后因素。方法本研究招募了2000年至2016年在我们机构接受治疗的> 40岁高级别骨肉瘤患者。收集患者、肿瘤和治疗相关因素的信息并进行统计学分析。所有患者的中位随访时间为26.5个月（范围5- 139个月）。诊断时的中位年龄为59.5岁（范围：41- 81岁）。原发病灶位于四肢32例，躯干12例，颅面骨6例。原发性骨肉瘤41例，继发性骨肉瘤9例。8例患者出现初始远处转移。39例患者分别行手术和化疗。新辅助化疗后的良好反应率为38%。所有患者和确诊时无远处转移患者的5年总生存率（OS）分别为44.5%和51.1%。多因素分析显示，在非转移性患者中，确定性手术是唯一显著的预后因素。接受确定性手术的非转移患者的5年OS和无病生存率（DFS）分别为64.3%和60%。在这些患者中，新辅助和/或辅助化疗显着改善OS和DFS.ConclusionsComplete手术切除和强化化疗，应进行骨肉瘤患者> 40岁，尽管从年轻患者的临床病理特征不同。
BackgroundFew studies have described the characteristics and prognostic factors of elderly patients with osteosarcoma. We retrospectively investigated clinico-pathological features and prognostic factors in osteosarcoma patients >40years old.MethodsPatients with high-grade osteosarcoma >40years old who were treated at our institutions from 2000 to 2016 were recruited for this study. Information on patient, tumour, and treatment-related factors was collected and statistically analyzed. The median follow-up was 26.5months (range, 5-139months) for all patients.ResultsFifty patients (30 males and 20 females) were included. The median age at diagnosis was 59.5years (range, 41-81years). The primary lesions were found in the limbs in 32 patients, trunk in 12, and craniofacial bones in six. Primary and secondary osteosarcoma occurred in 41 and 9 patients, respectively. Eight patients exhibited initial distant metastasis. Definitive surgery and chemotherapy were performed in 39 patients each. The rate of good responders after neoadjuvant chemotherapy was 38%. The fiveyear overall survival (OS) rates for all patients and those without distant metastasis at diagnosis were 44.5% and 51.1%, respectively. Multivariate analysis showed that definitive surgery was the only significant prognostic factor in non-metastatic patients. The fiveyear OS and disease-free survival (DFS) rates for non-metastatic patients who received definitive surgery were 64.3% and 60%, respectively. Among these patients, neoadjuvant and/or adjuvant chemotherapy significantly improved both OS and DFS.ConclusionsComplete surgical resection and intensive chemotherapy should be performed for osteosarcoma patients >40years old despite distinct clinicopathological characteristics from those of younger patients.