Osteosarcoma of the pelvis:: Experience of the Cooperative Osteosarcoma Study Group
Osteosarcoma of the pelvis:: Experience of the Cooperative Osteosarcoma Study Group
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DOI：
10.1200/jco.2003.01.142
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发表时间：
2003-01-15
影响因子：
45.3
通讯作者：
Bielack, SS
中科院分区：
文献类型：
--
作者：
Ozaki, T;Flege, S;Bielack, SS
目的：为了定义患者和肿瘤的特点以及治疗结果，骨盆骨肉瘤谁是在合作的骨肉瘤研究组（COSS）注册的患者进行了analyzed.Patients和方法：67例高级别骨盆骨肉瘤有资格进行这项分析。15例患者患有原发性转移瘤。所有患者均按照COSS方案进行化疗。38例患者接受了保肢手术，12例患者接受了半骨盆切除术，17例患者未接受确定性手术。11例患者接受放射治疗的原发肿瘤部位：4术后和7作为唯一的形式的局部therapeutic.Results：局部失败发生在47的所有67例（70%）和31的50例（62%）进行了明确的手术。5年总生存率（OS）和无进展生存率分别为27%和19%。肿瘤体积大（P = 0.0137）、原发性转移（P = 0.0001）、无手术或病灶内手术（P <0.0001）是预后不良的因素。在30例未接受手术或病灶内手术的患者中，11例接受放疗的患者的OS优于19例未接受放疗的患者（P = 0.0033）。在这些变量中，原发转移、大肿瘤、未手术或病灶内手术、未放疗、存在原发转移（相对风险[RR] = 3.456，P = .0009），手术切缘（病灶内或非手术切除; RR = 5.619; P < .0001），无放疗结论：广泛或边缘切缘的手术入路可改善局部控制和OS，如果手术切缘位于病灶内或无法切除，额外放疗对预后有积极影响。(C)2003年，美国临床肿瘤学会。
Purpose : To define patients and tumor characteristics as well as therapy results, patients with pelvic osteosarcoma who were registered in the Cooperative Osteosarcoma Study Group (COSS) were analyzed.Patients and Methods: Sixty-seven patients with a high-grade pelvic osteosarcoma were eligible for this analysis. Fifteen patients had primary metastases. All patients received chemotherapy according to COSS protocols. Thirty-eight patients underwent limb-sparing surgery, 12 patients underwent hemipelvectomy, and 17 patients did not undergo definitive surgery. Eleven patients received irradiation to the primary tumor site: four postoperatively and seven as the only form of local therapy.Results: Local failure occurred in 47 of all 67 patients (70%) and in 31 of 50 patients (62%) who underwent definitive surgery. Five-year overall survival (OS) and progression-free survival rates were 27% and 19%, respectively. Large tumor size (P = .0137), primary metastases (P = .0001), and no or intralesional surgery (P < .0001) were poor prognostic factors. In 30 patients with no or intralesional surgery, 11 patients with radiotherapy had better OS than 19 patients without radiotherapy (P = .0033). Among the variables, primary metastasis, large tumor, no or intralesional surgery, no radiotherapy, existence of primary metastasis (relative risk [RR] = 3.456, P = .0009), surgical margin (intralesional or no surgical excision; RR = 5.619; P < .0001), and no radiotherapy (RR = 4.196, P = .0059) were independent poor prognostic factors.Conclusion: An operative approach with wide or marginal margins improves local control and OS. If the surgical margin is intralesional or excision is impossible, additional radiotherapy has a positive influence on prognosis. (C) 2003 by American Society of Clinical Oncology.