Abstract：
BACKGROUND: While distant metastases in primary bone sarcomas have been extensively studied, the impact of isolated regional lymph node (LN) metastasis on survival remains unknown. In patients with primary bone sarcomas, we sought to assess the prevalence of isolated regional LN metastasis and the survival of this population.
METHODS: A total of 6651 patients with histologically-confirmed high-grade osteosarcoma, Ewing sarcoma, or chondrosarcoma were retrieved from the SEER database. We defined four subgroups for our analysis: localized disease (N0 M0), isolated regional LN metastasis (N1 M0), isolated distant metastasis (N0 M1), and combined regional LN and distant metastasis (N1 M1). Disease-specific survival (DSS) was assessed using the Kaplan-Meier method.
RESULTS: Prevalence of isolated regional LN metastasis (N1 M0) was highest in Ewing sarcoma (27/1097; 3.3 %), followed by chondrosarcoma (18/1702; 1.4 %) and osteosarcoma (26/3740; 0.9 %). In all three histologies, patients with isolated regional LN metastasis had a worse 2-year, 5-year, and 10-year DSS than those with localized disease. Chondrosarcoma patients with isolated regional LN (N1 M0) metastasis had a significantly higher DSS in comparison to those with only distant metastasis (N0 M1) at the 5- and 10-year marks; for osteosarcoma and Ewing sarcoma, only a pattern towards higher survival was seen. Risk factors for presenting isolated regional LN metastasis included tumor location in lower-limb (OR = 2.01) or pelvis (OR = 2.49), diagnosis of Ewing sarcoma (OR = 2.98), and tumor >10 cm (OR = 1.96).
CONCLUSIONS: Isolated regional LN metastases in primary bone sarcomas is an infrequent presentation associated with worse survival than localized disease.
METHODS: III.
METHODS: A total of 6651 patients with histologically-confirmed high-grade osteosarcoma, Ewing sarcoma, or chondrosarcoma were retrieved from the SEER database. We defined four subgroups for our analysis: localized disease (N0 M0), isolated regional LN metastasis (N1 M0), isolated distant metastasis (N0 M1), and combined regional LN and distant metastasis (N1 M1). Disease-specific survival (DSS) was assessed using the Kaplan-Meier method.
RESULTS: Prevalence of isolated regional LN metastasis (N1 M0) was highest in Ewing sarcoma (27/1097; 3.3 %), followed by chondrosarcoma (18/1702; 1.4 %) and osteosarcoma (26/3740; 0.9 %). In all three histologies, patients with isolated regional LN metastasis had a worse 2-year, 5-year, and 10-year DSS than those with localized disease. Chondrosarcoma patients with isolated regional LN (N1 M0) metastasis had a significantly higher DSS in comparison to those with only distant metastasis (N0 M1) at the 5- and 10-year marks; for osteosarcoma and Ewing sarcoma, only a pattern towards higher survival was seen. Risk factors for presenting isolated regional LN metastasis included tumor location in lower-limb (OR = 2.01) or pelvis (OR = 2.49), diagnosis of Ewing sarcoma (OR = 2.98), and tumor >10 cm (OR = 1.96).
CONCLUSIONS: Isolated regional LN metastases in primary bone sarcomas is an infrequent presentation associated with worse survival than localized disease.
METHODS: III.
摘要：
背景：虽然已经对原发性骨肉瘤的远处转移进行了广泛的研究，孤立区域淋巴结(LN)转移对生存的影响尚不清楚.在原发性骨肉瘤患者中，我们试图评估孤立区域LN转移的患病率和该人群的生存率.
方法：共6651例经组织学证实的高级别骨肉瘤患者，尤因肉瘤,或从SEER数据库检索软骨肉瘤.我们为我们的分析定义了四个亚组：局部疾病(N0M0)，孤立的区域LN转移（N1M0），孤立的远处转移（N0M1），合并区域LN和远处转移（N1M1）。使用Kaplan-Meier方法评估疾病特异性存活(DSS)。
结果：尤因肉瘤中孤立区域LN转移（N1M0）的患病率最高（27/1097；3.3％），其次是软骨肉瘤(18/1702;1.4%)和骨肉瘤(26/3740;0.9%)。在所有三种组织学中，有孤立区域LN转移的患者有一个更差的2年，5年,和10年DSS比那些有局部疾病。在5年和10年标记时，与仅有远处转移（N0M1）的患者相比，有孤立区域LN（N1M0）转移的软骨肉瘤患者的DSS明显更高；对于骨肉瘤和尤因肉瘤，只看到了更高存活率的模式。存在孤立区域LN转移的危险因素包括下肢（OR=2.01）或骨盆（OR=2.49）的肿瘤位置，尤因肉瘤的诊断（OR=2.98），肿瘤>10cm（OR=1.96）。
结论：原发性骨肉瘤中孤立的区域LN转移是一种罕见的表现，与局部疾病相比，其生存率较差。
方法：III.
方法：共6651例经组织学证实的高级别骨肉瘤患者，尤因肉瘤,或从SEER数据库检索软骨肉瘤.我们为我们的分析定义了四个亚组：局部疾病(N0M0)，孤立的区域LN转移（N1M0），孤立的远处转移（N0M1），合并区域LN和远处转移（N1M1）。使用Kaplan-Meier方法评估疾病特异性存活(DSS)。
结果：尤因肉瘤中孤立区域LN转移（N1M0）的患病率最高（27/1097；3.3％），其次是软骨肉瘤(18/1702;1.4%)和骨肉瘤(26/3740;0.9%)。在所有三种组织学中，有孤立区域LN转移的患者有一个更差的2年，5年,和10年DSS比那些有局部疾病。在5年和10年标记时，与仅有远处转移（N0M1）的患者相比，有孤立区域LN（N1M0）转移的软骨肉瘤患者的DSS明显更高；对于骨肉瘤和尤因肉瘤，只看到了更高存活率的模式。存在孤立区域LN转移的危险因素包括下肢（OR=2.01）或骨盆（OR=2.49）的肿瘤位置，尤因肉瘤的诊断（OR=2.98），肿瘤>10cm（OR=1.96）。
结论：原发性骨肉瘤中孤立的区域LN转移是一种罕见的表现，与局部疾病相比，其生存率较差。
方法：III.
