UNDIFFERENTIATED PLEOMORPHIC SARCOMA: PROGNOSTIC FACTORS IN 42 EXTREMITY CASES.

IF 0.5 4区 医学 Q4 ORTHOPEDICS
Carlos Henrique Maçaneiro, André Mathias Baptista, Olavo Pires DE Camargo, Renée Zon Filippi, Evandro Tito Oliveira
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Abstract

Introduction: Soft tissue undifferentiated pleomorphic sarcoma (UPS) in extremities is considered a rare neoplasm, corresponding to 5% of soft tissue sarcomas (STS) today. The objective was to evaluate prognostic factors related to death, local recurrence (LR), and impact on survival rates.

Methods: A retrospective study including 42 patients with UPS in extremities treated surgically in a single center. Comparisons were made between demographic data, characteristics of the neoplasia, and treatment. Between the variables with statistical significance, logistic regression analysis was used. Survival rates were evaluated using Kaplan-Meier plots. To compare the effect of variables on survival rates, the Log-Rank test was used.

Results: Age group of patients was from 25 to 85 years (mean 58 years), with a mean follow-up of 29.6 months. The variables with the highest effect on survival rates were sizes larger than 15 cm (T4) with p = 0.01, presence of metastatic lesions, and prognostic stage IV according to the American Joint Committee of Cancer (AJCC) with p < 0.001. The mean survival was 25.9 months. Metastasis and stage IV of AJCC were associated with a reduction in patient survival (17.8 months) with Log-Rank test p < 0.001. Conclusion: The main factors of poor prognosis related to mortality and reduction of survival of UPS in extremities were metastatic lesions and stage IV of AJCC. Level of Evidence III, Retrospective Study.

42例四肢未分化多形性肉瘤的预后因素分析。
四肢软组织未分化多形性肉瘤(UPS)被认为是一种罕见的肿瘤,相当于今天5%的软组织肉瘤(STS)。目的是评估与死亡、局部复发(LR)相关的预后因素以及对生存率的影响。方法:回顾性研究,包括42例在单一中心手术治疗的四肢UPS患者。比较了人口统计学资料、肿瘤特征和治疗方法。对具有统计学意义的变量进行logistic回归分析。生存率采用Kaplan-Meier图进行评估。为了比较各变量对生存率的影响,采用Log-Rank检验。结果:患者年龄25 ~ 85岁,平均58岁,平均随访29.6个月。根据美国癌症联合委员会(AJCC),对生存率影响最大的变量是尺寸大于15 cm (T4) (p = 0.01),转移灶的存在和预后阶段IV (p < 0.001)。平均生存期为25.9个月。转移和AJCC的IV期与患者生存期减少(17.8个月)相关,Log-Rank检验p < 0.001。结论:影响下肢UPS患者预后不良的主要因素是转移灶和AJCC的IV期。证据水平III,回顾性研究。
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来源期刊
CiteScore
0.90
自引率
14.30%
发文量
67
审稿时长
25 weeks
期刊介绍: A Revista Acta Ortopédica Brasileira, órgão oficial do Departamento de Ortopedia e Traumatologia da Faculdade de Medicina da Universidade de São Paulo (DOT/FMUSP), é publicada bimestralmente em seis edições ao ano (jan/fev, mar/abr, maio/jun, jul/ago, set/out e nov/dez) com versão em inglês disponível nos principais indexadores nacionais e internacionais e instituições de ensino do Brasil. Sendo hoje reconhecidamente uma importante contribuição para os especialistas da área com sua seriedade e árduo trabalho para as indexações já conquistadas.
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