Post-metastasis survival in extremity soft tissue sarcoma: A recursive partitioning analysis of prognostic factors
Post-metastasis survival in extremity soft tissue sarcoma: A recursive partitioning analysis of prognostic factors
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DOI：
10.1016/j.ejca.2014.03.003
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发表时间：
2014-06-01
影响因子：
8.4
通讯作者：
Han, Ilkyu
中科院分区：
文献类型：
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作者：
Kang, Seungcheol;Kim, Han-Soo;Han, Ilkyu
背景资料：递归分割分析（RPA）能够以直观的形式将患者分组为同质预后组，并能够解释预后变量之间的复杂相互作用。在这项研究中，我们采用RPA生成的预后模型四肢软组织肉瘤（STS）患者转移diseases.Methods：一个回顾性分析进行了135例转移性STS谁经历了手术切除原发肿瘤。分析患者和肿瘤变量沿着行乳腺切除术对转移后生存的可能预后影响。多因素分析的重要预后因素被纳入RPA建立回归树预测转移后survival.Results：RPA确定了6个终端节点的基础上，组织学分级，乳腺癌切除术的性能和无病间隔（DFI）。根据终末淋巴结的中位生存时间，将转移后生存期分为4组：（1）A组：低级别/直肠癌切除，（2）B组：低级别/未直肠癌切除/DFI ≥ 12个月或高级别/直肠癌切除，（3）C组：低级别/未直肠癌切除/DFI <12个月或高级别/未直肠癌切除/DFI P 12个月，（4）C组：低级别/未直肠癌切除/DFI < 12个月或高级别/未直肠癌切除/DFI P 12个月。（4）D组：高分级/未行输精管切除术/DFI < 12个月。各组的3年生存率分别为：A组，76.1 ± 9.6%; B组，42.3 ± 10.3%; C组，18.8 ± 8.0%; D组，0.0 ± 0.0%。结论：我们使用RPA的预后模型成功地将转移的STS患者分成了几组，这些组可以使用标准的临床参数容易地实现。(C)2014爱思唯尔有限公司版权所有。
Background: Recursive partitioning analysis (RPA) enables grouping of patients into homogeneous prognostic groups in a visually intuitive form and has the capacity to account for complex interactions among prognostic variables. In this study, we employed RPA to generate a prognostic model for extremity soft tissue sarcoma (STS) patients with metastatic disease.Methods: A retrospective review was conducted on 135 patients with metastatic STS who had undergone surgical removal of their primary tumours. Patient and tumour variables along with the performance of metastasectomy were analysed for possible prognostic effect on post-metastatic survival. Significant prognostic factors on multivariate analysis were incorporated into RPA to build regression trees for the prediction of post-metastatic survival.Results: RPA identified six terminal nodes based on histological grade, performance of metastasectomy and disease-free interval (DFI). Based on the median survival time of the terminal nodes, four prognostic groups with significantly different post-metastatic survival were generated: (1) group A: low grade/metastasectomy; (2) group B: low grade/no metastasectomy/DFI >= 12 months or high grade/metastasectomy; (3) group C: low grade/no metastasectomy/ DFI < 12 months or high grade/no metastasectomy/DFI P 12 months; and (4) group D: high grade/no metastasectomy/DFI < 12 months. The 3-year survival rates for each group were: group A, 76.1 +/- 9.6%; group B, 42.3 +/- 10.3%; group C, 18.8 +/- 8.0%; and group D, 0.0 +/- 0.0%.Conclusion: Our prognostic model using RPA successfully divides STS patients with metastasis into groups that can be easily implemented using standard clinical parameters. (C) 2014 Elsevier Ltd. All rights reserved.