儿童横纹肌肉瘤预后的影响因素分析

Prognostic Analysis of Pediatric Rhabdomyosarcoma

目的:探讨儿童横纹肌肉瘤(RMS)的临床病理特征及预后影响因素。方法:回顾性分析我科93例RMS患儿的临床及生存资料,引入患儿性别、年龄、肿瘤大小、原发部位、组织学类型、COG-stage分期、COG-group分期、危险度分组和手术情况共9个因素。采用COX回归模型进行多因素分析,确立影响预后的因素,采用Kaplan-Meier生存曲线和Log-rank检验比较影响因素与生存率的关系。结果:全组1年、3年、5年生存率分别为90.3%、62.0%、43.1%,总体中位生存期为47.28个月。多因素分析显示组织学类型、原发部位、group分期和是否手术切除是儿童RMS预后的影响因素。生存分析提示不同组织学类型、原发部位、group分期及是否手术切除的预后差异均有统计学意义(均P<0.001)。结论:儿童RMS预后的影响因素有组织学类型、原发部位、group分期和是否手术切除,通过此分析能为预后判断和临床治疗强度的选择提供依据。

Objective： To explore the clinicopathological characteristics and prognostic factors of pediatric rhabdomyosarcoma （RMS）. Methods： The clinical data of 93 patients with RMS were reviewed and analyzed including gender, age, tumor size, primary site, histological subtypes, COG-staging, COG-grouping, risk classification and option of surgery. COX regression model was used to do multivariate analysis to identify the independent prognostic factors. The relationship between the above factors and the survival rate was analyzed by Kaplan-Meier curve and Log-rank test. Results： The survival rates of one-year, three-year and five-year for patients with RMS were 90.3%, 62.0% and 43.1%, respectively. The median overall survival time was 47.28 months. Multivariate analysis showed that the histological subtypes, primary site, COG-grouping and option of surgery were independent prognostic factors. The survival analysis showed that there were significant differences in the prognostic differences among the histological subtypes, primary site, COG-grouping and option of surgery （all P〈 0.001）. Conclusion： The independent prognostic factors for pediatric RMS included histological subtypes, primary site, COG-grouping and option of surgery. These clinicopatholgical features can be used to predict the prognosis and provide basis for clinical treatment.