背景:软组织肉瘤是成人恶性肿瘤死亡的原因之一。这个肿瘤很罕见,持久性,而且经常发生。许多患者都是在晚期。确定可靠的预后工具很重要,容易获得,并广泛适用。本研究的目的是探讨和分析软组织肉瘤患者的临床病理和生物标志物的预后价值。
方法:这项回顾性研究从2012年1月至2018年12月在一家三级医院的肌肉骨骼肿瘤登记中提取数据。纳入80例诊断为软组织肉瘤的患者。术前改良格拉斯哥预后评分,中性粒细胞/淋巴细胞比率,血红蛋白,血清乳酸脱氢酶数据与人口统计学分析,临床,放射学和组织病理学数据。变量与总生存率之间的关系,远处转移,使用单变量和多变量Cox回归评估局部复发。
结果:关于单变量分析,血红蛋白之间有显著的关系,中性粒细胞/淋巴细胞比值和改良的格拉斯哥预后评分与总生存期(p=0.031,HR=1.99;p=0.04,HR=1.129;p=0.044,HR=3.89)。发现年龄和软组织肉瘤分期与远处转移之间存在显着关系(p=0.046,HR=1.95;p=0.00,HR=3.22)。此外,我们还发现手术切缘与局部复发之间存在显著关系(p=0.018,OR=3.44).然而,在多变量分析中,总生存期的独立预后因素仅是改良的格拉斯哥预后评分(HR=2.138;p=0.011).IIIA期(HR=5.32;p=0.005)和IIIB期(HR=13.48;p=0.00)是远处转移的独立预后。手术切缘与局部复发独立相关(HR=14.84;p=0.001)。
结论:改良的格拉斯哥预后评分可作为软组织肉瘤患者总生存期的预后工具。此外,STS分期和手术切缘可分别作为软组织肉瘤远处转移和局部复发的预后因素。
BACKGROUND: Soft tissue sarcoma is one cause of mortality in adult malignancies. This tumor is rare, persistent, and highly-recurrent. Many patients are came in late stage. It is important to identify a prognostic tool that is reliable, easily obtainable, and widely applicable. The aim of this
study is to investigate and analyze the prognostic value of clinicopathological and biomarker factors in patients with soft tissue sarcoma.
METHODS: This retrospective
study extracts data from the musculoskeletal tumor registry from January 2012 to December 2018 in a single tertiary hospital. Eighty patients with diagnosis of soft tissue sarcoma were included. Preoperative modified Glasgow Prognostic Score, Neutrophils/Lymphocytes Ratio, Hemoglobin, serum lactate dehydrogenase data were analyzed along with demographic, clinical, radiological and histopathological data. The relationship between variables on overall survival, distant metastasis, and local recurrence were evaluated using univariate and multivariate Cox regression.
RESULTS: On univariate analysis, there was significant relationship between hemoglobin, Neutrophils/Lymphocytes Ratio and modified Glasgow Prognostic Score with overall survival (p = 0.031, HR = 1.99; p = 0.04, HR = 1.129; and p = 0.044, HR = 3.89). A significant relationship was found between age and soft tissue sarcoma stage with distant metastasis (p = 0.046, HR = 1.95; and p = 0.00, HR = 3.22). In addition, we also found significant relationship between surgical margin with local recurrence (p = 0.018, OR = 3.44). However, on multivariate analysis the independent prognostic factor for overall survival was only modified Glasgow Prognostic Score (HR = 2.138; p = 0.011). Stage IIIA (HR = 5.32; p = 0.005) and IIIB (HR = 13.48; p = 0.00) were independent prognostic for distant metastasis. Surgical margin was independently associated with local recurrence (HR = 14.84; p = 0.001).
CONCLUSIONS: Modified Glasgow Prognostic Score can be used as prognostic tool of overall survival in soft tissue sarcoma patients. Moreover, stage of STS and surgical margin can be used as a prognostic factor for distant metastasis and local recurrence of soft tissue sarcoma respectively.