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日本48例骨平滑肌肉瘤:来自日本肌肉骨骼肿瘤学组的多中心研究。

Forty-eight cases of leiomyosarcoma of bone in Japan: A multicenter study from the Japanese musculoskeletal oncology group.

作者信息

Mori Tomoaki, Nakayama Robert, Endo Makoto, Hiraga Hiroaki, Tomita Masato, Fukase Naomasa, Kobayashi Eisuke, Kawai Akira, Ueda Takafumi, Morioka Hideo

机构信息

Department of Orthopaedic Surgery, School of Medicine, Keio University, Tokyo, Japan.

Division of Musculoskeletal Oncology, National Cancer Center Hospital, Tokyo, Japan.

出版信息

J Surg Oncol. 2016 Sep;114(4):495-500. doi: 10.1002/jso.24322. Epub 2016 Jun 15.

Abstract

BACKGROUND

Leiomyosarcoma of bone (LMSoB) is a rare malignant bone tumor. This multicenter retrospective study was conducted to investigate the diagnosis and the clinical outcome of primary LMSoB in Japan.

METHODS

Forty-eight patients (average age: 52 years [range 14-88 years]) with primary LMSoB who were treated at registered institutes in Japan between 1991 and 2014 were recruited. The median follow-up period was 44 months (range: 2-273).

RESULTS

The 5-year overall survival rates and disease-free survival rates were 78.3% and 44.9%, respectively. Surgical treatment was performed in 42 patients, and R0 resection was achieved in 31 patients. Neoadjuvant chemotherapy was administered in 18 patients. The most common regimen (cisplatin-based chemotherapy) was administered in 15 patients, however, no patient achieved a good response in both radiological and histological evaluations. The presence of metastasis at the first visit and a lack of definitive surgery were significantly correlated with poor overall survival, and the surgical margin was a significant prognostic factor for disease-free survival.

CONCLUSIONS

This study is the largest LMSoB case series ever reported. Surgical treatment with wide margins was the only treatment that proved to be effective, whereas adjuvant chemotherapy in the present setting did not improve the overall survival. J. Surg. Oncol. 2016;114:495-500. © 2016 Wiley Periodicals, Inc.

摘要

背景

骨平滑肌肉瘤(LMSoB)是一种罕见的恶性骨肿瘤。本多中心回顾性研究旨在调查日本原发性LMSoB的诊断及临床结果。

方法

招募了1991年至2014年间在日本注册机构接受治疗的48例原发性LMSoB患者(平均年龄:52岁[范围14 - 88岁])。中位随访期为44个月(范围:2 - 273个月)。

结果

5年总生存率和无病生存率分别为78.3%和44.9%。42例患者接受了手术治疗,31例患者实现了R0切除。18例患者接受了新辅助化疗。15例患者采用了最常见的方案(基于顺铂的化疗),然而,在影像学和组织学评估中均无患者获得良好反应。初诊时存在转移和缺乏确定性手术与总生存不良显著相关,手术切缘是无病生存的重要预后因素。

结论

本研究是迄今为止报道的最大规模的LMSoB病例系列。广泛切缘的手术治疗是唯一被证明有效的治疗方法,而目前情况下的辅助化疗并未改善总生存。《外科肿瘤学杂志》2016年;114:495 - 500。©2016威利期刊公司

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