PO.CL09.03 · 临床研究
短骨原发性骨肉瘤：一项基于监测、流行病学和最终结果项目（SEER）的回顾性研究
Primary osteosarcoma of the short bones: A Surveillance, Epidemiology, and End Results Program (SEER) retrospective study
作者与单位 Authors & Affiliations
摘要 Abstract
中文摘要
引言：
骨肉瘤（OS）是最常见的原发性骨实体恶性肿瘤，占所有儿童癌症的2%。OS最常见于四肢的长骨，尤其是股骨、胫骨和肱骨。然而，它很少见于上下肢的短骨。本研究旨在填补有关上下肢短骨OS的发病率、治疗和结局方面现有文献的空白。
方法：
利用美国国家癌症研究所监测、流行病学和最终结果（SEER）项目数据库识别原发性短骨OS病例，该数据库包含2000至2020年间的8,216,169例癌症病例。收集人口学、临床和治疗特征，并进行单变量和多变量回归分析，以确定疾病特异性生存与肿瘤扩散、肿瘤大小、肿瘤分级、手术类型和原发部位之间的关系。
结果：
原发性短骨OS病例占数据库中所有OS病例的2.2%。大多数病例为男性，最常见的年龄组为15至39岁。在201例患者队列中，58.2%接受了化疗，4.5%接受了放疗。170例患者有手术信息——该组中50.6%接受了保肢手术，31.8%的患者接受了截肢，17.6%未接受手术。单变量分析显示分级和疾病扩散是具有统计学意义的生存预测因素；然而，在多变量分析中，只有局限性疾病与更好的疾病特异性生存相关。有趣的是，接受截肢治疗的患者与接受保肢手术的患者之间没有生存差异。
结论：
本研究结果证实，该部位的OS是一种罕见疾病，其人口学分布总体上与更常见的长骨变异型相似。结果还表明，鉴于保肢手术与截肢之间缺乏生存差异，保肢是该群体合理的治疗选择。
查看英文原文 English abstract
Introduction:
Osteosarcoma (OS) is the most common primary solid malignancy of bone and accounts for 2% of all childhood cancers. OS is most often found in the long bones of the extremities, in particular the femur, tibia, and humerus. However, it is rarely found in the short bones of the upper and lower extremity. This study seeks to address the existing gap in the literature on the incidence, treatment, and outcomes of OS of the short bones of the upper and lower extremity.
Methods:
Cases of primary short bone OS were identified using the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) Program database, containing 8,216,169 cancer cases from 2000 to 2020. Demographic, clinical, and treatment characteristics were collected, and univariate and multivariate regression analysis was conducted to determine the relationship between disease-specific survival and tumor spread, tumor size, tumor grade, surgery type, and primary site.
Results:
Cases of primary short bone OS made up 2.2% of all OS cases in the database. The majority of cases were male, and the most common age group ranged from ages 15 to 39. Within the 201-patient cohort, 58.2% were treated with chemotherapy and 4.5% received radiation therapy. Surgery information was available for 170 patients-50.6% of that group underwent limb-sparing surgery, 31.8% of patients underwent amputation, and 17.6% did not have surgery. Univariate analysis revealed grade and disease spread to be statistically significant predictors of survival; however, upon multivariate analysis, only localized disease was correlated with better disease-specific survival. Interestingly, there was no survival difference between patients treated with amputation versus patients who underwent limb salvage surgery.
Conclusions:
The results of this study confirm that OS of this location is a rare entity that generally follows the demographic distribution of the more common long bone variant. The results also signal that limb salvage is a reasonable treatment option for this group, given the lack of survival difference between limb salvage surgery and amputation.
利益披露 Disclosure
J. Imamura, None.