单中心23例儿童骨肉瘤(SCMC-OS-2012)远期随访

Retrospective analysis and summary of 23 childhood osteosarcoma(SCMC-OS-2012)in a single centre

目的分析儿童骨肉瘤(SCMC-OS-2012)方案下疗效及影响预后因素,为今后治疗方案的改进提供依据。方法研究对象为2013年1月—2019年7月我院新诊断骨肉瘤,共25例。根据UICC TNM分期系统分为转移组和非转移组,综合治疗方案包括手术及化疗联合应用,手术分为保肢手术和截肢手术。对骨肉瘤资料进行生存率及影响因素的分析。结果连续病例共25例,符合入组分析23例,男性13例,女性10例,男女比例1.3∶1,发病中位年龄10.5(3.6~15.5)岁,生存者中位随访时间36(12~87)个月。患儿3年总生存率(OS)78.3%±8.6%(95%CI:50.182-79.991);3年无事件生存率(EFS)71.7%±10.1%(95%CI:43.001-76.303),单因素分析发现:初诊时年龄分组、性别、肿瘤部位及大小、手术方式与预后无关。有否远处转移及化疗敏感性(肿瘤病理坏死率)具有明显统计学意义,P值均<0.05。Cox模型多因素分析结果表明,是否有远处转移是影响预后的独立相关影响因素。结论本中心骨肉瘤(SCMC-2012-OS)患儿临床特征及预后与国际数据基本一致;初诊时远处转移及化疗敏感性明显影响预后。

Objective To determine treatment outcomes in pediatric patients with osteosarcoma(OS)treated at the Shanghai Children′s Medical Center(SCMC).Methods A retrospective chart review of 25 pediatric patients with osteosarcoma diagnosed between Feb 2013 through Jul 2019 was performed.According to the UICC TNM stage,the patients were divided into nonmetastatic group and metastatic group.Comprehensive treatment included surgery and chemotherapy,surgery was divided into limb salvage surgery(LSS)and amputations.The Kaplan-Meier survival analysis and Cox regression multivariate analysis were used to assess prognostic factors for overall survival(OS)and event-free survival(EFS).Results 23 patients were admitted to this study,13 males and 10 females,aged 3.6-15.5 years old(with median of 10.5years old).The median follow-up was 36 months(12-87months).The 3-year OS and EFS for all patients were 78.3%±8.6%(95%CI:50.182-79.991)and 71.7%±10.1%(95%CI:43.001-76.303)respectively.Univariate analysis showed that metastatic at presentation,higher histologic response to chemotherapy were associated with worse prognosis(P<0.05).However,gender,primary sites age,tumor size SLL or not were not the relevant influencing factors of survival and prognosis(P>0.05)Cox regression multivariate analysis showed that metastasis was independent influencing factors of survival and prognosis of children with osteosarcoma.Conclusions The clinical characeristics and prognosis of osteosarcoma patients in SCMC is quite similarly to the worldwide data.Patients with metastatic disease at presentation and poor histologic response to chemotherapy have a worse prognosis.