手足部骨肉瘤的临床特征及预后分析  

Clinical characteristics and prognosis of patients with osteosarcoma of the hands and feet

作　　者：王春燕[1] 汤丽娜[2] 胡蓓蓓[2] 祁伟祥[2] 张剑军[2] 郑水儿[2] 姚阳[2] 林峰[2] 

机构地区：[1]苏州大学医学部,江苏苏州215000 [2]上海交通大学附属第六人民医院肿瘤内科,上海200233

出　　处：《肿瘤》2014年第9期850-853,867,共5页Tumor

摘　　要：目的：比较手足部骨肉瘤患者与四肢长骨骨肉瘤患者的临床特征和预后。方法：回顾性分析2002年1月－2012年1月收治的20例手足部骨肉瘤患者和40例四肢长骨骨肉瘤患者的临床资料，并进行随访，随访时间为10～80个月。比较手足部骨肉瘤患者和四肢长骨骨肉瘤患者的年龄、性别、新辅助化疗、病理类型、保肢率、除肺以外的其他部位的远处转移率、局部复发率和肺转移率，以及出现局部复发和肺转移的时间差异。应用Kaplan-Meier法进行生存分析。结果：两组患者的性别、除肺以外的其他部位的远处转移率、保肢率、局部复发率和肺转移率的差异均无统计学意义（P〉0．05）。手足部骨肉瘤患者发病年龄〉20岁的比例（P〈0．001）、未行新辅助化疗的比例（P=0．006）以及特殊病理类型骨肉瘤所占的比例（P=0．021）均高于四肢长骨骨肉瘤患者；手足部骨肉瘤患者出现局部复发的时间（P=0．002）和肺转移的时间（P=0．009）均较四肢长骨骨肉瘤患者的长。手足部骨肉瘤患者的中位生存时间为66．0个月（95％的可信区间为55．1～76．9个月），四肢长骨骨肉瘤患者的中位生存时间为46．0个月（95％的可信区间为25．4～66．6个月），前者的生存时间明显长于后者（P=0．044）。结论：手足部骨肉瘤患者的临床特征有异于四肢长骨骨肉瘤患者，且前者的预后优于后者。Objective： To compare the clinical characteristics and prognosis between the patients with osteosarcoma of the hands and feet and the patients with osteosarcoma of four limbs. Methods： The clinical records of patients with osteosarcoma of the hands and feet （n = 20） and those with osteosarcoma of four limbs （n = 40） between January 2002 and January 2012 were retrospectively reviewed. The follow-up time was 10-80 months. The factors including gender, age, neoadjuvant chemotherapy, pathologic type, limb- salvage rate, metastasis rate of other sites （not lung）, local recurrence rate, lung metastasis rate, time to local recurrence and time to lung metastasis were compared between osteosarcoma of the hands and feet and the osteosarcoma of four limbs. Kaplan-Meier method was used for survival analysis. Results： There were no significant differences in terms of gender, metastasis of other sites （not lung）, limb salvage rate, local recurrence rate and lung metastasis rate between the osteosarcoma of the hands and feet and the osteosarcoma of four limbs （P 〉 0.05）. The proportions of patients aged 20 years or more （P 〈 0.001）, without neoadjuvant chemotherapy （P = 0.006）, and having typical pathology （P = 0.021） were significantly higher in the patients with osteosarcoma of the hands and feet than those in the patients with osteosarcoma of four limbs. The time to local recurrence （P = 0.002） and time to lung metastasis （P = 0.009） were both longer in the patients with osteosarcoma of the hands and feet. The median survival time of the patients with osteosarcoma of the hands and feet and those with osteosarcoma of four limbs were 66.0 months （95% confidence interval： 55.1-76.9）and 46.0 months （95% confidence interval： 25.4-66.6）, respectively （P = 0.044）. Conclusion： The characteristics of patients with osteosarcoma of the hands and feet are different from those of the patients with osteosarcoma of four limbs, and the prognosis of osteosarcoma of the hands

关 键 词：骨肉瘤 手足 骨 预后 

分 类 号：R738.1[医药卫生—肿瘤]