24例中老年原发性骨肉瘤的临床报道  

Primary osteosarcoma in middle-aged and elderly patients: A report of 24 cases

作　　者：李菊明[1] 许晶晶[1] 张琦[1] 韦永中[1] Li Juming;Xu Jingjing;Zhang Qi;Wei Yongzhong(Department of Orthopedics, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China)

机构地区：[1]南京医科大学第一附属医院骨科

出　　处：《实用肿瘤杂志》2019年第3期249-252,共4页Journal of Practical Oncology

摘　　要：目的探讨中老年原发性骨肉瘤患者的临床诊治及预后情况。方法回顾性分析24例中老年(≥40岁)原发性骨肉瘤患者的临床资料,并对患者的复发和转移情况进行随访。结果 24例患者平均年龄54岁(40~76岁),男女比例为3∶1。肿瘤位于肢体骨10例(41.7%),位于中轴骨8例(33.3%),位于骨外软组织6例(25.0%)。2例(8.3%)诊断时已出现远处转移,所有患者均接受手术治疗,其中22例行新辅助化疗方案。术后6例局部出现肿瘤复发(25.0%),9例(37.5%)诊断后出现转移,最常见的转移部位是肺部。所有患者3年无瘤生存率(disease free survival,DFS)和总体生存率(overall survival,OS)分别为41.7%和50.0%。无肿瘤转移患者3年DFS和OS分别为53.8%和76.9%。出现肿瘤转移的患者3年OS为45.5%。结论中老年患者骨肉瘤预后较差,早期诊治联合新辅助化疗有助于提高OS。Objective To investigate the clinical diagnosis, treatment and prognosis of middle-aged and elderly patients with primary osteosarcoma. Methods The clinical data of 24 cases of primary osteosarcoma in the middle-aged and elderly(≥40 years old) were retrospectively analyzed, and the patients′ recurrence and metastasis were followed up. Results The average age of the 24 patients was 54 years(range 40-76), and the ratio of male to female was 3∶1. Tumor was located in limb bone in 10 cases(41.7%), in axial bone in 8 cases(33.3%), and in extraspinal soft tissue in 6 cases(25.0%). Two patients(8.3%) had distant metastasis at the time of diagnosis. All patients received surgical treatment, and 22 patients underwent neoadjuvant chemotherapy. Six patients(25.0%) had local tumor recurrence after operation, and 9 patients(37.5%) had metastasis. The most frequent metastatic site was lung. The 3-year disease-free survival(DFS) and overall survival(OS) rates of all patients were 41.7% and 50.0%, respectively. The 3-year DFS and OS rates of patients without tumor metastasis were 53.8% and 76.9%, respectively, while the 3-year OS rate in patients with tumor metastasis was 45.5%. Conclusion Osteosarcoma has a poor prognosis in middle-aged and elderly patients. Early diagnosis and treatment combined with neoadjuvant chemotherapy is helpful to improve OS.

关 键 词：骨肿瘤/外科学 骨肿瘤/药物疗法 骨肉瘤/外科学 骨肉瘤/药物疗法 骨肉瘤/诊断 化学疗法 辅助 存活率 肿瘤转移 预后 老年人 

分 类 号：R738.1[医药卫生—肿瘤] R730.56[医药卫生—临床医学]