骨盆软骨肉瘤临床特点和预后因素分析

Clinical characteristics and prognostic factors of pelvic chondrosarcoma

目的·分析骨盆软骨肉瘤临床特点和预后因素,为临床诊治提供参考。方法·收集73例软骨肉瘤患者病例资料,其中24例为骨盆软骨肉瘤。总结骨盆软骨肉瘤的临床特点,分析其预后因素。结果·24例骨盆软骨肉瘤患者中,男女比1.4:1,中位年龄43.5岁。按Enneking骨盆肿瘤分区,Ⅰ区5例,Ⅱ区14例,Ⅲ区5例;组织学分级为软骨肉瘤I级的1例,Ⅱ级15例,Ⅲ级8例;组织学类型为普通中央型17例,去分化型3例,继发型2例,黏液型、间质型各1例。24例患者3、5和10年总生存率分别为(82.2±8.1)%、(77.3±8.9)%、(52.4±12.1)%。骨盆软骨肉瘤手术切除后局部复发率(83.3%)高于其他部位(34.7%),差异有统计学意义(P=0.000);最终接受截肢手术的比例(50.0%)也高于其他部位(20.4%),差异有统计学意义(P=0.000);但2组总生存时间比较,差异无统计学意义(P=0.216)。结论·骨盆软骨肉瘤局部复发率较高,更易导致截肢;术后较早复发,提示其预后不佳。

Objective · To summarize the clinical characteristics and prognostic factors of pelvic chondrosarcoma. Methods · A total of 73 cases of chondrosarcoma were collected, including 24 of pelvic. The clinical characteristics and prognostic factors of pelvic chondrosarcoma were analyzed by statistic methods. Results · The ratio of men to women was 1.4：1,and the median age is 43.5 years old. According to the classification of pelvic proposed by Enneking, there were 5 in region Ⅰ？, 14 in region Ⅱ？, and 5 in region Ⅲ？. On histological review, 1 was grade 1, 15 were grade 2 ,and 8 were grade 3. The histologic types included 17 conventional, 3 dedifferentiated, 2 secondary, and 1 mesenchymal. The overall survival rates of pelvic chondrosarcoma were （82.2±8.1） %,（77.3±8.9） % and（52.4±12.1） % for 3, 5 and 10 years respectively. Local recurrence rate of pelvic chondrosarcoma （83.3%） was significantly higher than those of other sites （34.7%）（P=0.000）, and the proportion of amputation was significantly higher than the other sites （50.0% vs 20.4%, P=0.000）, but there was no significant difference in the overall survival between the two groups （P=0.216）. Conclusion · Pelvic chondrosarcoma have a higher local recurrence rate than the other sites and is tend to result in amputation. Early local recurrence after surgery indicates poor prognosis.