CAJ | 학술논문

目的：确定原发成人骨肉瘤患者的相关预后因素。方法：对1998年10月到2011年10月在北京大学人民医院骨肿瘤中心接收治疗的54例年龄超过40岁的成年骨肉瘤患者（其中男性24例，女性30例）的临床资料进行回顾性分析。结果：肿瘤位于肢体骨30例（55．5％）、中轴骨17例（31．5％）、骨外软组织7例（13％），6例患者（11．1％）在诊断时伴有其他部位转移，52例患者（96．3％）接受了手术治疗，14例患者局部复发（26．9％），21例患者（38．9％）诊断后出现转移。52例接受手术治疗的骨肉瘤患者5年的无病生存率和总体生存率分别为43．7％和50．4％。结论：造成成人骨肉瘤患者预后较差的因素很多，外科边界不充分、肿瘤更多来源于中轴部位、在诊断时已有远处转移以及肿瘤体积巨大，都与较差的生存率显著相关，积极地多元联合治疗有助于提高生存率。
목적：학정원발성인골육류환자적상관예후인소。방법：대1998년10월도2011년10월재북경대학인민의원골종류중심접수치료적54례년령초과40세적성년골육류환자（기중남성24례，녀성30례）적림상자료진행회고성분석。결과：종류위우지체골30례（55．5％）、중축골17례（31．5％）、골외연조직7례（13％），6례환자（11．1％）재진단시반유기타부위전이，52례환자（96．3％）접수료수술치료，14례환자국부복발（26．9％），21례환자（38．9％）진단후출현전이。52례접수수술치료적골육류환자5년적무병생존솔화총체생존솔분별위43．7％화50．4％。결론：조성성인골육류환자예후교차적인소흔다，외과변계불충분、종류경다래원우중축부위、재진단시이유원처전이이급종류체적거대，도여교차적생존솔현저상관，적겁지다원연합치료유조우제고생존솔。
Objective: To determine the prognostic factors of primary osteosarcoma in adults . Methods:This is a review of 54 patients older than 40 years (24 men and 30 women) who were treated between 1998 and 2011 at the authors ’ institution .Demographic information and follow-up data were obtained and statistically analyzed .Results: Tumors involved the limbs in 30 patients ( 55 .5%) and axial skeleton in 17 patients (31.5%), and arose from soft tissue in 7 patients (13%).And 6 patients (11.1%) had synchronous metastasis .According to our review , tumors were treated surgically in 52 patients (96.3%).Local recurrence was documented in 14 patients (26.9%).Metastasis after diagno-sis appeared in 21 patients (38.9%).In the 52 patients who received the surgical treatment , the 5 year disease-free survival and overall survival rates were 43.7% and 50.4%, respectively.Conclusion:Adult patients with primary osteosarcoma had a poor clinical outcome .Inadequate surgical margins , more tumors in the axial location due to high recurrence rates , metastatic disease at presentation , and large tumor volumes were associated with significantly lower survival rates .Aggressive multi-agent treatment regimens might improve survival .