Primary pulmonary synovial sarcoma.
Primary pulmonary synovial sarcoma.
复制标题
原发性肺滑膜肉瘤。
DOI：
10.1016/j.xjon.2022.02.014
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发表时间：
2022-06
期刊：
影响因子：
--
通讯作者：
Ye, Cong
中科院分区：
文献类型：
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作者：
Wang, Weixi;Guo, Junhong;Bao, Minwei;Liu, Xiaogang;Wang, Hao;Ye, Cong
原发性肺滑膜肉瘤（PPSS）极为罕见。本研究旨在确定影响PPSS患者生存的临床病理和治疗因素。我们对来自监测、流行病学和最终结果数据库的121例患者以及来自我们自己机构诊断为PPSS的12例患者进行了回顾性分析。采用Kaplan-Meier法评估患者生存期。本院12例PPSS患者的中位生存时间为78个月。术后化疗（总生存期P = 0.027，疾病特异性生存期P = 0.035）与较好的生存期相关，而全肺切除术（总生存期P = 0.011，疾病特异性生存期P = 0.006）与较差的生存期相关。单叶受累性（P = 0.022）和无淋巴结受累性（P = 0.045）分别与疾病特异性生存期和总生存期的改善相关。在监测、流行病学和最终结果数据库中，中位生存时间为23个月。早期美国癌症联合委员会分期（Ⅰ-Ⅱ）患者的生存率显著提高（总生存率和疾病特异性生存率均P < 0.001）。最近10年内确诊的患者并没有获得更好的生存率（总生存率P = 0.599，疾病特异性生存率P = 0.596）。PPSS是侵袭性的，预后很差。第七届美国癌症分期联合委员会可能有助于预测生存率。全肺切除术和淋巴结受累可能与较差的生存率相关，而单叶受累和术后化疗可能与改善生存率相关。从我们的单一机构和SEER数据库中分别确定了12例和121例原发性肺滑膜肉瘤患者。单中心组的中位生存期为78个月，SEER组的中位生存期为23个月。近十年来，总体存活率在人口水平上并没有增加。来自单一机构的单因素分析显示，原发部位、化疗、全肺切除术和淋巴结转移可能是生存的决定因素，而在SEER数据库中，晚期AJCC与较差的结果独立相关。
Primary pulmonary synovial sarcoma (PPSS) is extremely rare. This study aims to identify the clinicopathologic and therapeutic factors determining survival in PPSS. We performed a retrospective analysis of 121 patients from the Surveillance, Epidemiology, and End Results Database as well as 12 patients from our own institution diagnosed with PPSS. Patient survival was evaluated using the Kaplan-Meier method. The median survival time for 12 PPSS patients in our institution was 78 months. Postoperative chemotherapy (P = .027 for overall survival and P = .035 for disease-specific survival) was associated with superior survival, whereas pneumonectomy (P = .011 for overall survival and P = .006 for disease-specific survival) was associated with worse survival. Single lobe involvement (P = .022) and the absence of lymph node involvement (P = .045) were associated with improved disease-specific survival and overall survival, respectively. In the Surveillance, Epidemiology, and End Results Database, the median survival time was 23 months. Significantly superior survival was observed in patients with earlier American Joint Committee on Cancer stage (Ⅰ-Ⅱ) (P < .001 for both overall survival and disease-specific survival). Patients who were diagnosed within the recent decade did not achieve a better survival (P = .599 for overall survival and P = .596 for disease-specific survival). PPSS was aggressive with a very poor prognosis. The seventh American Joint Committee on Cancer stage might aid in predicting survival. Pneumonectomy and lymph node involvement might be associated with worse survival, whereas single lobe involvement and postoperative chemotherapy might be associated with improved survival. A total of 12 and 121 patients with primary pulmonary synovial sarcoma were identified from our single institution and the SEER database, respectively. The median survival was 78 months for the single center and 23 months in the SEER registry. Overall survival was not increased in the recent decade at the population level. Univariate analysis from the single institution revealed that primary site, chemotherapy, pneumonectomy, and lymph node metastasis might be determinants of survival, whereas advanced AJCC stage was independently associated with worse outcomes in the SEER database.