[Analysis of clinical features, treatment methods, and prognostic influence factors in patients with malignant peripheral nerve sheath tumor].

Q3 Medicine
Bochong Shi, Haoyu Zheng, Huajian Wu, Xianglin Hu, Wangjun Yan
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引用次数: 0

Abstract

Objective: To investigate the clinical features, treatment methods, and prognostic influence factors of patients with malignant peripheral nerve sheath tumor (MPNST).

Methods: A retrospective analysis was conducted on 96 MPNST patients treated between January 1, 2015 and December 31, 2021. There were 46 males and 50 females, aged between 15 and 87 years (mean, 48.2 years). The tumors were located in the trunk in 50 cases, extremities in 39 cases, and head and neck in 7 cases. The maximum tumor diameter was <5 cm in 49 cases, ≥5 cm in 32 cases, with 15 cases missing data. Tumor depth was deep in 77 cases and superficial in 19 cases. The Fédération Nationale des Centres de Lutte Contre le Cancer (FNCLCC) histological grading was G1 in 9 cases, G2 in 12 cases, and G3 in 34 cases, with 41 cases missing data. There were 37 recurrent MPNST cases, 32 cases with neurofibromatosis type 1 (NF1), and 26 cases in stage Ⅳ. Postoperative adjuvant radiotherapy was administered to 25 patients, perioperative chemotherapy to 45 patients, and anlotinib-targeted therapy to 30 patients. R 0 resection was achieved in 73 cases. Patients were divided into groups based on the presence or absence of NF1, and baseline data between the two groups were compared. Kaplan-Meier curves were generated to assess disease-free survival (DFS) and overall survival (OS) based on various factors (age, gender, presence of NF1, recurrent MPNST, stage Ⅳ MPNST, FNCLCC grade, R 0 resection, tumor location, tumor size, tumor depth, perioperative chemotherapy, postoperative adjuvant radiotherapy, and anlotinib-targeted therapy), and differences between survival curves were analyzed using the Log-Rank test. Multivariate COX proportional hazards regression was used to identify independent prognostic factors for MPNST.

Results: Patients with NF1 had a significantly higher proportion of superficial tumors and lower FNCLCC grade compared to those without NF1 ( P<0.05); no significant difference was found for other variables ( P<0.05). Kaplan-Meier analysis showed that recurrent MPNST, stage Ⅳ MPNST, FNCLCC grade, R 0 resection, perioperative chemotherapy, and anlotinib-targeted therapy were factors influencing 1-year DFS ( P<0.05), while stage Ⅳ MPNST, FNCLCC grade, and perioperative chemotherapy were factors affecting 3-year OS ( P<0.05). Multivariate COX proportional hazards regression analysis revealed that recurrent MPNST and high-grade FNCLCC (G3) were independent prognostic factors for 1-year DFS ( P<0.05), while stage Ⅳ MPNST, superficial tumor depth, age over 60 years, postoperative adjuvant radiotherapy, and anlotinib-targeted therapy were independent prognostic factors for 3-year OS ( P<0.05).

Conclusion: MPNST patients with NF1 tend to have more superficial tumors and lower FNCLCC grades. FNCLCC grade, R 0 resection, and adjuvant therapies, including radiotherapy and anlotinib-targeted therapy, are closely associated with MPNST prognosis. Complete surgical resection should be prioritized in clinical management, along with adjuvant treatments such as radiotherapy and targeted therapy of anlotinib to improve patient outcomes.

[恶性周围神经鞘瘤患者的临床特征、治疗方法和预后影响因素分析]。
目的研究恶性周围神经鞘瘤(MPNST)患者的临床特征、治疗方法和预后影响因素:对2015年1月1日至2021年12月31日期间接受治疗的96名恶性周围神经鞘瘤患者进行回顾性分析。其中男性 46 人,女性 50 人,年龄在 15 至 87 岁之间(平均 48.2 岁)。肿瘤位于躯干的有50例,位于四肢的有39例,位于头颈部的有7例。肿瘤最大直径为 0 的患者有 73 例。根据是否存在 NF1 将患者分为几组,并比较两组患者的基线数据。根据各种因素(年龄、性别、有无NF1、复发性MPNST、Ⅳ期MPNST、FNCLCC分级、R 0切除、肿瘤位置、肿瘤大小、肿瘤深度、围手术期化疗、术后辅助放疗和安罗替尼靶向治疗)生成Kaplan-Meier曲线,评估无病生存期(DFS)和总生存期(OS),并使用Log-Rank检验分析生存曲线之间的差异。采用多变量COX比例危险回归确定MPNST的独立预后因素:结果:与非NF1患者相比,NF1患者的浅表肿瘤比例明显更高,FNCLCC分级更低(PP0切除、围手术期化疗和安罗替尼靶向治疗是影响1年DFS的因素(PPPPC结论:患有 NF1 的 MPNST 患者往往肿瘤较浅,FNCLCC 分级较低。FNCLCC分级、R 0切除和辅助治疗(包括放疗和安罗替尼靶向治疗)与MPNST预后密切相关。在临床治疗中,应优先考虑完全手术切除,同时进行放疗和安罗替尼靶向治疗等辅助治疗,以改善患者预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
中国修复重建外科杂志
中国修复重建外科杂志 Medicine-Medicine (all)
CiteScore
0.80
自引率
0.00%
发文量
11334
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