20岁以下接受根治性手术后原发性骨肉瘤患者的预后相关影响因素

Prognostic factors of primary osteosarcoma patients under 20 years old undergoing radical surgery

目的探讨影响<20岁根治性手术后原发性骨肉瘤患者的预后独立因素,以此来预测患者的预后生存,方法回顾性分析美国国立癌症研究所监测、流行病学和结果数据库(SEER)中1984年-2014年确诊并登记的1339例原发性骨肉瘤患者的临床病理资料,应用Kaplan-Meier法计算患者的生存率,logrank检验评价生存差异,并根据Cox多因素分析结果确定影响根治性手术后原发性骨肉瘤预后的独立因素:结果根据<20岁接受根治性手术的骨肉瘤患者的分析结果发现,0~5岁34例(2.54%),6~10岁236例(17.63%),11~15岁600例(44.81%),16~20岁469例(35.02%)。中位生存期68个月。其中757(56.53%)例为男性,582(43.47%)例为女性。1339例中白种人986例(73.64%),其次是黑种人230例(17.18%),其他种族123例(9.18%)。通过多变量分析发现男性(HR=1.242;95%CI:1.024-1.505)、中轴骨骨肉瘤(HR=1.589:95%CI:1.179~2.166)、骨肉瘤区域侵犯(HR=1.470;95%CI:1.156~1.870)、远处转移(HR=3.536;95%CI:2.725~4.589)是总体生存率的独立性危险因素。其他类型骨肉瘤(HR=0.471;95%CI:0.285~0.779)是总体生存率独立性保护因素结论基于SEKK数据库,本研究确定<20岁接受根治性手术后原发性骨肉瘤患者预后的独立影响因素,这将有助于临床医生制定个体化的医疗策略并预测患者预后。

Objective To explore the independent prognostic factors of primary osteosarcoma patients under 20 years old after radical surgery,so as to predict the prognosis and survival of patients.Methods The clinicopathological data of 1339 patients with primary osteosarcoma diagnosed and registered in the National Cancer Institute Surveillance,epidemiology and outcome database(SEER)from 1984 to 2014 were retrospectively analyzed.Kaplan Meier method was used to calculate the survival rate of patients.Log rank test was used to evaluate the survival difference.Cox multivariate analysis was used to determine the independent prognostic factors of osteosarcoma after radical surgery factor.Results The results of primary osteosarcoma patients undergoing radical surgery found thal 34 cases(2.54%)aged 0—5 years old,236 cases(17.63%)aged 6-10 years old,and 600 cases(44.81%)aged 11-15 years old and 469 cases(35.02%)aged 16-20 years old.The median survival time was 68 months.Among them,757(56.53%)were male and 582(43.47%)were female.Among the 1339 cases,986 were white(73.64%),followed by black 230(17.18%),and 123 other races(9.18%).Multivariate analysis revealed that males(HR=1.242;95%C/:1.024-1.505),axial osteosarcoma(HR=1.589;95%C/:1.179-2.166),and regional invasion of osteosarcoma(HR=1.470;95%CI:1.156-1.870),distant metastasis(HR=3.536;95%C7:2.725-4.589)were independent risk factors for overall survival.Other types of osteosarcoma(HR=0.471;95%CI:0.285-0.779)were independent protective factors for overall survival.Conclusions Based on the SEER database,this study identified independent prognostic factors for patients with primary osteosarcoma under the age of 20 who underwent radical surgery,which will help clinicians formulate individualized medical strategies and predict patients,prognosis.