Survival after second and subsequent recurrences in osteosarcoma: a retrospective multicenter analysis
Survival after second and subsequent recurrences in osteosarcoma: a retrospective multicenter analysis
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DOI：
10.1177/0300891617753257
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发表时间：
2018-06-01
期刊：
影响因子：
1.9
通讯作者：
Fagioli, Franca
中科院分区：
文献类型：
--
作者：
Tirtei, Elisa;Asaftei, Sebastian D.;Fagioli, Franca
目的：骨肉瘤（Osteosarcoma， OS）是最常见的原发性骨肿瘤。尽管进行了完全的手术切除和强化化疗，30%-35%的OS患者仍有局部或全身复发。部分患者多次复发存活，但OS复发后的总生存率较差。本分析旨在描述和确定影响第二次OS复发后复发后生存（PRS）的因素。方法：回顾性分析2003年至2013年意大利2个中心60例肢体OS二次复发患者。结果：第一次和随后的复发治疗是根据机构指南计划的。在第一次复发后完全手术缓解（CSR）后，患者经历了第二次OS复发，中位无病间隔（DFI）为6个月。肺部疾病普遍存在：44例（76%）患者有肺转移。第二次复发后的5年生存率为22%。与其他复发部位（5%,p = 0.008）相比，肺部疾病仅与5年生存率较高相关（33.6%）。单肺病变患者的5年第二PRS较好（42%;p = 0.02）。实现第二次CSR的患者5年第二次PRS为33.4%。化疗(p
Purpose: Osteosarcoma (OS) is the most common primary bone tumor. Despite complete surgical removal and intensive chemotherapeutic treatment, 30%-35% of patients with OS have local or systemic recurrence. Some patients survive multiple recurrences, but overall survival after OS recurrence is poor. This analysis aims to describe and identify factors influencing post-relapse survival (PRS) after a second OS relapse.Methods: This is a retrospective analysis of 60 patients with a second relapse of OS of the extremities in 2 Italian centers between 2003 and 2013.Results: Treatment for first and subsequent relapses was planned according to institutional guidelines. After complete surgical remission (CSR) following the first recurrence, patients experienced a second OS relapse with a median disease-free interval (DFI) of 6 months. Lung disease was prevalent: 44 patients (76%) had pulmonary metastases. Survival after the second relapse was 22% at 5 years. Lung disease only correlated with better survival at 5 years (33.6%) compared with other sites of recurrence (5%; p = 0.008). Patients with a single pulmonary lesion had a better 5-year second PRS (42%; p = 0.02). Patients who achieved a second CSR had a 5-year second PRS of 33.4%. Chemotherapy (p