CAJ | 학술논문

目的分析影响滑膜肉瘤患者预后的相关因素.方法回顾性分析1997年9月至2008年9月就诊的66例滑膜肉瘤患者中52例获得随访的患者的临床资料.其中男性28例,女性24例;发病年龄11～71岁,均以无痛性肿块入院.通过随访了解肿瘤学预后,明确3、5年总体生存率及局部复发率.通过回顾病例,分析年龄、性别、肿瘤部位、肿瘤直径、外科边界、病理亚型、局部治疗方式、是否侵及骨与神经血管以及是否化疗9项因素对总体生存率的影响.利用Kaplan-Meier生存分析确定对生存有影响的单个因素,并通过Cox回归分析明确影响预后的独立危险因素.结果 52例患者获得随访,随访率78.8％;随访时间6 ～ 88个月,中位随访时间32个月.患者5年总体生存率为30.3％,局部复发率为32.7％,中位复发时间16个月.单因素分析结果提示:肿瘤直径＜5 cm、取得广泛外科边界、肿瘤位于四肢以及采取广泛切除联合局部放疗的患者预后较好(P＜0.05).多因素分析显示肿瘤直径,部位以及是否取得广泛外科边界是影响预后的独立危险因素.结论肿瘤直径、部位以及是否取得广泛外科边界是影响预后的独立危险因素.
목적 분석영향활막육류환자예후적상관인소.방법 회고성분석1997년9월지2008년9월취진적66례활막육류환자중52례획득수방적환자적림상자료.기중남성28례,녀성24례;발병년령11～71세,균이무통성종괴입원.통과수방료해종류학예후,명학3、5년총체생존솔급국부복발솔.통과회고병례,분석년령、성별、종류부위、종류직경、외과변계、병리아형、국부치료방식、시부침급골여신경혈관이급시부화료9항인소대총체생존솔적영향.이용Kaplan-Meier생존분석학정대생존유영향적단개인소,병통과Cox회귀분석명학영향예후적독립위험인소.결과 52례환자획득수방,수방솔78.8％;수방시간6 ～ 88개월,중위수방시간32개월.환자5년총체생존솔위30.3％,국부복발솔위32.7％,중위복발시간16개월.단인소분석결과제시:종류직경＜5 cm、취득엄범외과변계、종류위우사지이급채취엄범절제연합국부방료적환자예후교호(P＜0.05).다인소분석현시종류직경,부위이급시부취득엄범외과변계시영향예후적독립위험인소.결론 종류직경、부위이급시부취득엄범외과변계시영향예후적독립위험인소.
Objective To determine the independent prognostic factors of primary synovial sarcoma.Methods The clinical data of 52 patients followed up from 66 patients with synovial sarcoma treated between September 1997 and September 2008 was analyzed retrospectively.There were 28 male and 24 female patients aged from 11 to 71 years old.Three and five-year overall survival (OS),recurrence rate and 9 prognostic factors were analyzed in this study.Univariate and multivariate analysis were performed to determine the prognostic factors of OS.Results Fifty-two patients were followed up with the follow-up time ranged from 6 to 88 months (median 32 months).The 3-,5-year overall survival rate and local recurrence rate were 52.8％,30.3％ and 32.7％ respectively.Univariate showed tumor size ＜5 cm,tumor located at extremities,adequate surgical margin and radical resection combined with radiotherapy had better survival rate (P ＜ 0.05 ).Multivariate analysis demonstrated that tumor size,primary site and adequate surgical margin were independent prognostic factors for OS.Patients received radical resection combined with radiotherapy have longer median relapse time(25 months) compared with marginal resection combined with radiotherapy( 18 months) and single radical resection ( 12 months).Thirty-five (67％) patients were treated with chemotherapy and seventeen (33％) patients received no chemotherapy for the primary tumor.Treatment with chemotherapy was not associated with an improved OS ( P =0.52 ).Conclusions The independent prognostic factors of synovial sarcoma are tumor size,primary site and adequate surgical margin.Doxorubicin and ifosfamide based chemotherapy was not associated with an improved OS in patients with synovial sarcoma.Radical resection combined with radiotherapy can best control local condition.