肺转移患者早期n期骨肉瘤切除术的生存获益：一项回顾性研究

IF 3.8 3区医学 Q1 SURGERY

Asian Journal of Surgery Pub Date : 2025-09-01 DOI:10.1016/j.asjsur.2025.05.124

Conglin Ren, Mingshuang Li, Caijian He, Kuanglin Li

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引用次数: 0

摘要

骨肉瘤（OS）是一种预后较差的高度恶性骨肿瘤，尤其是伴有肺转移（LM）的患者。指南不建议对伴有LM的OS患者进行手术切除。然而，一些研究表明，手术可能能够延长生存时间。在这里，我们的目的是研究LM的危险因素，并通过分析一个国家队列来评估癌症直接手术（CDS）的生存获益。方法收集2010-2019年诊断为骨、关节肿瘤的患者共60例。统计转移灶的发生率和分布情况。所有符合条件的OS患者组成研究队列，探讨LM的危险因素，然后生成诊断nomogram。接下来，将294例患者分为CDS组和非CDS组。采用Kaplan-Meier法和Cox比例风险模型评价CDS的疗效。结果本研究共纳入OS患者1925例，其中发生LM 294例。OS患者发生LM的独立危险因素包括病理分级、T分期、N分期和肿瘤大小。在预后分析中，CDS似乎显著延长了中位总生存期，尤其是早期TN患者。森林危险比图显示，化疗也能提高生存率，而年龄的增长对生存率有负面影响。结论本研究揭示了LM发生的危险因素及CDS对TN早期患者的突出价值，可为临床医生制定治疗决策提供重要参考。

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Survival benefit of resection of early TN-stage osteosarcoma in patients with lung metastasis: A retrospective study

Background

Osteosarcoma (OS) is a highly malignant bone tumor with poor prognosis, especially for patients with lung metastasis (LM). The guidelines do not recommend resection surgery for OS patients with LM. However, some studies showed that surgery may be able to prolong the survival. Here, we aimed to investigate the risk factors for LM and assess survival benefit of cancer-direct surgery (CDS) by analyzing a national cohort.

Methods

OS patients diagnosed in 2010–2019 with tumors located in the bone and joint was downloaded. The incidence of metastasis and distribution of metastatic foci were counted. All eligible OS patients were used to form a study cohort to explore risk factors for LM and then diagnostic nomogram was generated. Next, 294 patients were categorized into CDS and non-CDS groups. The benefits of CDS were evaluated by Kaplan-Meier method and Cox proportional hazard model.

Results

A total of 1925 OS patients were involved in current study, of which 294 cases developed LM. The independent risk factors for LM in OS patients include pathological grade, T stage, N stage and tumor size. In prognostic analyses, CDS appeared to significantly prolong median overall survival, especially for patients at early TN stage. Forest plot by hazard ratio showed that chemotherapy also improved survival, while advancing age had a negative effect.

Conclusion

Our study reveals the risk factors for LM and the prominent value of CDS for patients at early TN stage, which could provide important references for clinicians to make treatment decisions.

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来源期刊

Asian Journal of Surgery 医学-外科

CiteScore

3.60

自引率

31.40%

发文量

1589

审稿时长

33 days

期刊介绍： Asian Journal of Surgery, launched in 1978, is the official peer-reviewed open access journal of the Asian Surgical Association, the Taiwan Robotic Surgery Association, and the Taiwan Society of Coloproctology. The Journal is published monthly by Elsevier and is indexed in SCIE, Medline, ScienceDirect, Scopus, Embase, Current Contents, PubMed, Current Abstracts, BioEngineering Abstracts, SIIC Data Bases, CAB Abstracts, and CAB Health. ASJSUR has a growing reputation as an important medium for the dissemination of cutting-edge developments in surgery and its related disciplines in the Asia-Pacific region and beyond. Studies on state-of-the-art surgical innovations across the entire spectrum of clinical and experimental surgery are particularly welcome. The journal publishes original articles, review articles, and case reports that are of exceptional and unique importance. The journal publishes original articles, review articles, and case reports that are of exceptional and unique importance.