59例青少年及儿童骨肉瘤患儿远期预后影响因素分析

Analysis of Factors Affecting Long-term Prognosis of 59 Cases of Osteosarcoma in Adolescents and Children

目的探讨59例青少年及儿童骨肉瘤患儿远期预后影响因素。方法选择59例青少年及儿童骨肉瘤患儿,所有患儿均给予手术及术后辅助化疗,采用Kplan-Meier法对患儿的术后总生存率进行计算,采用单因素分析法对随访资料进行分析,采用Cox比例风险回归模型行多因素分析。结果 59例患儿中,术后3年患儿生存41例,死亡18例,生存率为69. 5%(41/59)。单因素分析结果表明,KPS评分、Enneeking分期、辅助化疗次数与青少年和儿童骨肉瘤患儿的远期预后相关,而性别、年龄、肿瘤部位、肿瘤大小、病理性骨折、肿瘤类型、手术类型与青少年和儿童骨肉瘤的远期预后无关。多因素分析结果表明,KPS评分、Enneeking分期、辅助化疗次数是影响青少年和儿童骨肉瘤的远期预后的独立相关影响因素。结论规范的辅助化疗可提高患儿的生存率,KPS评分、Enneeking分期是影响青少年、儿童骨肉瘤预后的独立危险因素。

Objective To investigate the factors affecting the long-term prognosis of 59 cases of osteosarcoma in adolescents and children. Methods 59 cases of osteosarcoma in adolescents and children were selected,who were given surgery and postoperative adjuvant chemotherapy. The postoperative overall survival rate of the children was calculated by Kplan-meier method,the univariate analysis was used to analyze the above follow-up data. The multivariate analysis was by Cox proportional risk regression model. Results Among the 59 cases,41 cases survived 3 years after surgery,and 18 cases died,the survival rate was69. 5%( 41/59). The results of univariate analysis showed that the KPS score,Enneeking stage and the adjuvant chemotherapy number were correlated with the long-term prognosis of pediatric osteosarcoma in adolescents and children,the gender,age,tumor site,tumor size,pathological fracture,tumor type and surgical type were not related to the long-term prognosis of osteosarcoma in adolescents and children. The multivariate analysis showed that the KPS score,Enneeking stage and the adjuvant chemotherapy number were independent factors affecting the long-term prognosis of osteosarcoma in adolescents and children. Conclusion Standard adjuvant chemotherapy could improve the survival rate of children. The KPS score and Enneeking stage were independent risk factors on the prognosis of osteosarcoma in adolescents and children.