反复复发的多重瘤的逆皮质脂肉瘤的预测因素和结果
Huan Deng1,2, Xingming Xu2, Jingwang Gao2
1Department of Gastrointestinal Surgery, Peking University First Hospital, Beijing, China.
Frontiers in medicine
|September 25, 2023
概括
与多个瘤一起复发的逆皮质脂肪瘤 (RLS) 表明预后不佳. 通过名录模型识别预后因素有助于为这些具有挑战性的病例制定个性化治疗策略.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 医学统计 医学统计
背景情况:
- 逆皮质脂肉瘤 (RLS) 是一种罕见且具有攻击性的恶性瘤.
- 多个瘤的复发是一个重大的治疗挑战.
- 复发性RLS与多个瘤的临床结果和生存预测因素需要阐明.
研究的目的:
- 在患有复发性RLS和多重瘤的患者中确定整体生存 (OS) 和无进展生存 (PFS) 的独立预后因素.
- 开发和验证用于预测生存结果的诺莫格拉姆模型.
- 评估特定复发模式,如局部复发 (LR) 对治疗疗效的影响.
主要方法:
- 对113名患有复发性RLS和多重瘤的患者进行了回顾性分析.
- 单变量和多变量考克斯比例危险回归分析以确定预后因素.
- 开发和内部验证用于生存预测的诺莫格拉姆模型.
- 卡普兰-梅尔分析和日志等级测试用于生存评估.
主要成果:
- 一年,3年和5年的OS率分别为70.7%,35.9%和30.9%,一年,3年和5年的PFS率为所有时间点的76.1%.
- 手术数量,切除方法,瘤大小,病理差异化,病理亚型和复发模式是显著的预后因素 (p < 0.05).
- 局部复发 (LR) 患者的预后不佳,并没有从联合器官切除或R0/R1切除中受益 (p < 0.05).
结论:
- 复发性RLS与多个瘤相关,预后不佳,需要经常的术后随访.
- 纳米图模型包含关键预后因素,可以指导个性化临床管理.
- 积极的手术策略可能无法改善LR模式患者的生存率.
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