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JAMA OHNS：颌骨骨肉瘤临床特征及其预后风险因素研究

2015-03-27 Zhang JL译 MedSci原创

颌骨骨肉瘤预后生存期

颌骨骨肉瘤是罕见的骨肉瘤，其临床特征与身体其他的长骨中的骨肉瘤不同，其治疗方式和预后也存在差异。目前，针对这一类型骨肉瘤的文献报道往往只是个案或者单一机构的小样本报道。研究人员利用以人群为基础的国家监测、流行病学与最终结果(SEER) 的癌症注册数据来确定颌骨骨肉瘤的流行病学和相关预后因素。这项研究结果发表在最新一期JAMA Otolaryngol Head Neck Surg杂志上。该研究目的在

颌骨骨肉瘤是罕见的骨肉瘤，其临床特征与身体其他的长骨中的骨肉瘤不同，其治疗方式和预后也存在差异。目前，针对这一类型骨肉瘤的文献报道往往只是个案或者单一机构的小样本报道。研究人员利用以人群为基础的国家监测、流行病学与最终结果(SEER) 的癌症注册数据来确定颌骨骨肉瘤的流行病学和相关预后因素。这项研究结果发表在最新一期JAMA Otolaryngol Head Neck Surg杂志上。

该研究目的在于研究颌骨骨肉瘤的流行病学特点和生存及预后因素。研究人员通过一项基于人群的回顾性队列研究，对1973年至2011年间SEER肿瘤登记的被诊断为颌骨骨肉瘤的541名患者的资料进行分析。研究主要终点为总体生存率（OS）及疾病特异生存率（DSS）。


该研究总共入组541名被诊断为颌骨骨肉瘤的患者，其中包括49.9%男性和50.1%的女性，平均年龄为41.3岁。Kaplan-Meier分析显示总生存期(OS)和特定疾病生存(DSS)分别为53%和62%，而5年生存率和10年生存率分别为35%和54%。


多变量Cox回归分析显示，OS和DSS的独立预测因子包括诊断时年龄 (OS的危险比[HR]为1.03，95%置信区间为1.02-1.04，P<0.001；DSS的危险比[HR]为1.03，95%置信区间为1.02-1.05，P <0.001)；分期(OS的危险比[HR]为1.37，95%置信区间为1.37-1.10，P=0.006；DSS的危险比[HR]为1.34，95%置信区间为1.01-1.76，P=0.004)；



手术切除(OS的危险比[HR]为0.31，95%置信区间为0.31-0.16，P<0.001；DSS的危险比[HR]为0.22，95%置信区间为0.09-0.56，P=0.001)。肿瘤大小与OS关系不显著(危险比[HR]为1.00，95%置信区间为1.00-1.01，P=0.11)，但与DSS关系显著(危险比[HR]为1.01，95%置信区间为1.00-1.01，P=0.003)。

据研究人员所知，这是迄今为止最大的调查颌骨骨肉瘤患者生存及预后因素的研究。生存的决定因素包括诊断时年龄、分期、肿瘤大小和手术治疗。放射治疗与延长生存时间无显著相关，反映了其在临床使用中的争议。

原始出处：
Lee RJ, Arshi A, Schwartz HC, Christensen RE. Characteristics and Prognostic Factors of Osteosarcoma of the Jaws: A Retrospective Cohort Study. JAMA Otolaryngol Head Neck Surg. Published online March 26, 2015. doi:10.1001/jamaoto.2015.0340.

评论区 (3)
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    2015-10-20 yeye5224612

    #临床特征#

    0

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    2015-05-24 ljjj1053

    不错，学习了

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1842848, encodeId=88f21842848e7, content=<a href='/topic/show?id=112222886b8' target=_blank style='color:#2F92EE;'>#临床特征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=123, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22886, encryptionId=112222886b8, topicName=临床特征)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=yeye5224612, createdTime=Tue Oct 20 17:45:00 CST 2015, time=2015-10-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=24685, encodeId=4acc246852a, content=不错，学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=153, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=ac181616815, createdName=ljjj1053, createdTime=Sun May 24 12:26:00 CST 2015, time=2015-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=18968, encodeId=586618968a4, content=样本量很大, beContent=null, objectType=article, channel=null, level=null, likeNumber=173, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c4a5105539, createdName=lovetcm, createdTime=Fri Mar 27 21:29:00 CST 2015, time=2015-03-27, status=1, ipAttribution=)]
    2015-03-27 lovetcm

    样本量很大

    0