[Analysis of factors influencing the efficacy and prognosis of surgical treatment for primary malignant pelvic bone tumors].
Zhonghua Zhong Liu Za Zhi
; 46(4): 344-353, 2024 Apr 23.
Article
in Zh
| MEDLINE
| ID: mdl-38644270
ABSTRACT
Objective:
To analyze the prognostic factors and the influence of surgical margin to prognosis.Methods:
A retrospective analysis was performed for 208 pelvic tumors who received surgical treatment from January 2000 to December 2017 in our instituition. Survival analysis was performed using the Kaplan-Meier method and Log rank test, and impact factor analysis was performed using Cox regression models.Results:
There were 183 initial patients and 25 recurrent cases. According to Enneking staging, 110 cases were stage â B and 98 cases were stage â ¡B. 19 lesions were in zone â , 1 in zone â ¡, 15 in zone â ¢, 29 in zone â +â ¡, 71 in zone â ¡+â ¢, 29 in zone â +â £, 35 in zone â +â ¡+â ¢, 3 in zone â +â ¡+â £, and 6 in zone â +â ¡+â ¢+â £. Surgical margins including Intralesional excision in 7 cases, contaminated margin in 21 cases, marginal resection in 67 cases, and wide resection in 113 cases. Local recurrence occurred in 37 cases (17.8%), 25 cases were performed by reoperation and 12 cases received amputation finally. The 5-year recurrence rate of marginal resection was higher than wide resection (Pï¼0.05), and the recurrence-free survival rate of marginal resection was lower than wide resection (Pï¼0.05). There was significant differences in recurrence rate and recurrence-free survival rate between R0 and R1 resection (Pï¼0.05). 92 cases were not reconstructed and 116 cases were reconstructed after pelvic surgery. At the last follow-up, 63 patients (30.3%) died, and the 5-year, 10-year and 15-year survival rates were 70.4%, 66.8% and 61.3%, respectively. The 5-year survival rate of stage â B and â ¡B tumor was 90.4% and 46.8%, respectively. There were 29 cases had postoperative wound complications (13.8%), 1 case with pelvic organ injury. The final function was evaluated in 132 patients, with an average MSTS score of 25.1±3.6. Cox multivariate analysis showed that surgical staging, R0/R1 margin and metastasis were independent prognostic factors for pelvic tumors.Conclusions:
The safe surgical margin is the key factor for recurrence-free of pelvic tumor. The survival rate of stage â ¡B pelvic tumors was significantly lower than that of stage â B tumors. Wound infection is the main postoperative complication. Surgical staging, R0/R1 margin and metastasis were independent prognostic factors of pelvic tumors.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Pelvic Bones
/
Bone Neoplasms
/
Margins of Excision
/
Neoplasm Recurrence, Local
Limits:
Female
/
Humans
/
Male
Language:
Zh
Journal:
Zhonghua Zhong Liu Za Zhi
Year:
2024
Document type:
Article
Affiliation country:
China
Country of publication:
China