Time dependence of prognostic factors for patients with soft tissue sarcoma -: A Scandinavian Sarcoma Group Study of 338 mailignant fibrous histiocytomas
Time dependence of prognostic factors for patients with soft tissue sarcoma -: A Scandinavian Sarcoma Group Study of 338 mailignant fibrous histiocytomas
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DOI：
10.1002/cncr.20254
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发表时间：
2004-05-15
期刊：
影响因子：
6.2
通讯作者：
Nilbert, M
中科院分区：
文献类型：
--
作者：
Engellau, J;Anderson, H;Nilbert, M
背景软组织肉瘤转移的预后因素决定了辅助治疗的决定。然而，随着时间的推移，初始肿瘤相关的预后因素的意义在很大程度上是未知的。本研究纳入了338例四肢或躯干壁恶性纤维组织细胞瘤（MFH）患者，其肿瘤由斯堪的纳维亚肉瘤病理学审查组审查。在这338名患者中，329名（97%）患有高级别肿瘤。中位随访期为7年。在中位随访14个月后，338例患者中有110例发生转移，大约三分之一（110例中有32例）发生在2年后。作者研究了肿瘤大小、肿瘤深度、组织学分级、显微镜下肿瘤坏死、血管浸润、有丝分裂率和局部肿瘤复发在不同时间间隔的预后意义，以转移为终点。在单变量分析中，发现所有研究因素在整个随访期间以及随访的前2年都与转移相关;在此时间点之后，只有大小、肿瘤深度和局部复发具有显著性。在多变量分析中，坏死和局部肿瘤复发在整个随访期间和前2年随访期间都有意义，而只有肿瘤深度和局部复发在超过2年随访时才有意义。对于所有初始因素，高风险组和低风险组的年转移风险在2年后收敛到< 0.1，5年后接近0。MFH转移的预后因素是时间依赖性的。初始预后因素的预测价值仅限于随访的前2年。2年随访后观察到的预后价值的缺乏可能归因于测量误差和未知生物学变异导致的风险类别内的异质性。癌症2004;100：2233-41. (C)2004年美国癌症协会。
BACKGROUND. Prognostic factors for metastasis in soft tissue sarcoma govern decisions regarding adjuvant treatment. However, the significance of initial tumor-related prognostic factors over time is largely unknown.METHODS. The current study included 338 patients with malignant fibrous histiocytoma (MFH) of the extremities or the trunk wall whose tumors were reviewed by the Scandinavian Sarcoma Pathology Review Group. Of these 338 patients, 329 (97%) had high-grade tumors. The median follow-up period was 7 years. Metastases occurred in 110 of 338 of patients after a median follow-up period of 14 months, with roughly one-third (32 of 110) occurring after 2 years. The authors investigated the prognostic significance of tumor size, tumor depth, histologic grade, microscopic tumor necrosis, vascular invasion, mitotic rate, and local tumor recurrence at various time intervals using metastases as an endpoint.RESULTS. On univariate analysis, all investigated factors were found to be correlated with metastases for the entire follow-up period and also for the first 2 years of follow-up; beyond this time point, only size, tumor depth, and local recurrence were significant. On multivariate analysis, necrosis and local tumor recurrence were significant for the entire follow-up duration and also for the first 2 years of follow-up, whereas only tumor depth and local recurrence were significant beyond 2 years of follow-tip. For all initial factors, the annual metastasis risks in the high-risk and low-risk groups converged to < 0.1 after 2 years and to near 0 after 5 years.CONCLUSIONS. Prognostic factors for metastasis in MFH were time dependent. The predictive value of the initial prognostic factors was limited to the first 2 years of follow-up. The lack of observed prognostic value beyond 2 years of follow-up probably was attributable to heterogeneity within risk categories as a result of measurement errors and unknown biologic variations. Cancer 2004;100:2233-41. (C) 2004 American Cancer Society.