透明细胞肉瘤的临床治疗与预后分析.pdf

. . 中国骨肿瘤骨病2010年10月第9卷第5期 Chin J Bone Tumor Bone Disease, October 2010, Vol 9, No.5 429 . 临床论著 . 透明细胞肉瘤的临床治疗与预后分析 商冠宁　孙平　邢浩　郑珂　王玉名　王巍 作者单位：110042 沈阳，辽宁省肿瘤医院骨软组织肿瘤科 【摘要】　目的　探讨透明细胞肉瘤的临床特点及治疗方法，分析治疗效果及影响因素。方法　对1990年－ 2009年连续治疗的38例病理证实透明细胞肉瘤的患者进行回顾性分析。结果　全部病例随访时间４－242个月 (平均34个月)。发生转移26例，局部复发９例。全部病例的５年复发率23.7%，５年和10年转移率分别为61.0% P 和68.4%，转移风险累积明显大于局部复发( =0.004)。转移、局部复发、死亡的中位时间为分别为13个月，19个 P 月和20个月。全部病例的５年、10年生存率分别为47%、36%。单因素分析结果显示性别( =0.018)，肿瘤大小 P P P P P ( =0.001)，肿瘤深度( =0.002)，TNM分期性( =0.001)及手术切缘( =0.042)可能成为预后因素。而化疗( =0.18)、 P P 放疗( =0.06)与肿瘤预后无明显相关。在多变量分析中，只有肿瘤大小( =0.021)成为独立的预后因素。结论　早 期诊断和首次广泛切除是改善透明细胞肉瘤预后的关键。肿瘤大小与转移关系密切，是影响预后的重要因素。 【关键词】　透明细胞肉瘤；预后因素；肿瘤大小；化疗 doi:10.3969/j.issn.1671-1971.2010.05.014 Treatment and prognosis analysis of clear cell sarcoma SHANG Guanning, SUN Ping, XING Hao, et al. Bone Soft Tissue Departartment of Surgery, Liaoning Cancer Hospital, Shenyang, Liaoning 110042, PRC Abstract Objective To investigate the clinical features of and the treatment for clear cell sarcoma (CCS), 【 】 and to analyse the efficacy and and prognosis factors. Methods A total of 38 consecutive patients who were confirmed to have CCS with histological test were treated between 1990 and 2009. They were studied retrospectively. Results All patients were followed up for 4 though 242 months, 34 months on average. 26 patients were confirmed to have m