Treatment outcome of chest wall soft tissue sarcomas: Analysis of prognostic factors
Treatment outcome of chest wall soft tissue sarcomas: Analysis of prognostic factors
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DOI：
10.1002/jso.25708
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发表时间：
2019-09-19
影响因子：
2.5
通讯作者：
Yamashita, Toshihiko
中科院分区：
文献类型：
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作者：
Nakahashi, Naoya;Emori, Makoto;Yamashita, Toshihiko
背景原发性软组织肉瘤（STS）累及胸壁并不常见。本研究的目的是确定影响原发性胸壁STS患者预后的因素。方法回顾性分析2002年至2018年在我院治疗的38例患者的病历资料。以下变量被评估为潜在的预后因素：性别、肿瘤大小、化疗和手术切缘的完整性。进行多因素分析以确定总生存期（OS）和无病生存期（DFS）的预测因素。结果38例患者中，5例为低度恶性肿瘤，33例为高度恶性肿瘤。5例患者需要胸壁重建，包括肋骨切除。30例患者（79%）接受了R 0切除术。5年OS和DFS率分别为45%和27%。局部复发7例。多变量分析确定肿瘤大小（风险比[HR]：4.13; 95%置信区间[CI]：1.05-16.24; P = 0.04）和R1/2切除（HR：3.92; 95% CI：1.12-13.66; P = 0.03）为OS的预测因素。结论生存的预后因素包括肿瘤大小和手术切缘的完整性。完全切除肿瘤是可取的，特别是在早期发现的情况下。
Background Primary soft tissue sarcomas (STSs) involving the chest wall are uncommon. The aim of this study was to identify factors that influence the prognosis of patients with primary chest wall STS. Methods The records of 38 patients (23 men and 15 women) who were treated at our institutions during 2002 to 2018 were reviewed. The following variables were evaluated as potential prognostic factors: sex, tumor size, chemotherapy, and completeness of surgical margins. Multivariate analysis was conducted to identify predictors of overall survival (OS) and disease-free survival (DFS). Results Of the 38 included patients, 5 had low-grade tumors and 33 had high-grade tumors. Five patients required chest wall reconstruction including rib resection. Thirty patients (79%) underwent R0 resection. The 5-year OS and DFS rates were 45% and 27%, respectively. Local recurrence developed in 7 patients. Multivariate analysis identified tumor size (hazard ratio [HR]: 4.13; 95% confidence interval [CI]: 1.05-16.24; P = .04) and R1/2 resection (HR: 3.92; 95% CI: 1.12-13.66; P = .03) as predictors of OS. Conclusions Prognostic factors for survival included tumor size and completeness of surgical margins. Complete tumor excision is desirable, particularly in cases of early detection.