文章：

腹膜后罕见化疗敏感亚型肉瘤的围手术期系统治疗：一项基于医院的倾向评分匹配分析

Perioperative Systemic Therapy in Rare, Chemosensitive Subtypes of Retroperitoneal Sarcoma: A Hospital-Based Propensity Score-Matched Analysis

原文发布日期：10 June 2025

DOI: 10.3390/cancers17121931

类型: Article

开放获取: 是

英文摘要：

Background:There is an ongoing debate about the role of perioperative chemotherapy in retroperitoneal sarcoma (RPS). The aim of this study was to evaluate the effectiveness of perioperative chemotherapy in subtypes of RPS that are considered chemosensitive, including retroperitoneal angiosarcoma, undifferentiated pleomorphic sarcoma, myxoid liposarcoma, spindle cell sarcoma, and synovial sarcoma.Methods:This is a population-based retrospective cohort study. Patients with localized retroperitoneal sarcoma who underwent surgery were included from the US National Cancer Database (NCDB). After propensity score matching for the factors age, sex, grade, margin status, and tumor size, multivariable logistic and Cox regression analyses were used to identify factors associated with systemic therapy and their potential impact on the survival of patients with localized RPS.Results:We included 851 patients who underwent surgery between 2004 and 2020 (85% white, 41% female, and mean age 62 years). Of those, 227 patients (26.7%) received perioperative chemotherapy. In multivariable logistic regression, age ≤ 60 and tumor grading GIII/IV vs. GI/II were associated with a higher probability of receiving perioperative chemotherapy. After propensity score matching, we detected no difference in overall survival between patients who received chemotherapy and those who did not (HR 0.89, CI 0.55–1.43; and log-rankp= 0.92). Patient age ≤80 and tumor grading GI/II vs. GIII/IV were associated with improved overall survival.Conclusions:In this large analysis, the use of perioperative chemotherapy was not associated with improved survival in rare, chemosensitive subtypes of retroperitoneal sarcoma. However, selection bias must be considered when interpreting these findings.

摘要翻译： 

背景：关于围手术期化疗在腹膜后肉瘤（RPS）中的作用一直存在争议。本研究旨在评估围手术期化疗在特定被认为对化疗敏感的RPS亚型中的有效性，这些亚型包括腹膜后血管肉瘤、未分化多形性肉瘤、黏液样脂肪肉瘤、梭形细胞肉瘤以及滑膜肉瘤。 方法：本研究为一项基于人群的回顾性队列研究。数据来源于美国国家癌症数据库（NCDB），纳入了接受手术的局限性腹膜后肉瘤患者。在针对年龄、性别、肿瘤分级、切缘状态及肿瘤大小等因素进行倾向评分匹配后，采用多变量逻辑回归和Cox回归分析，以确定与全身治疗相关的因素及其对局限性RPS患者生存的潜在影响。 结果：研究共纳入851例在2004年至2020年间接受手术的患者（85%为白人，41%为女性，平均年龄62岁）。其中，227例患者（26.7%）接受了围手术期化疗。多变量逻辑回归分析显示，年龄≤60岁以及肿瘤分级为GIII/IV（相较于GI/II）与接受围手术期化疗的概率较高相关。经过倾向评分匹配后，我们发现接受化疗的患者与未接受化疗的患者在总生存期上无显著差异（风险比HR 0.89，置信区间CI 0.55–1.43；对数秩检验p=0.92）。患者年龄≤80岁以及肿瘤分级为GI/II（相较于GIII/IV）与总生存期的改善相关。 结论：在这项大规模分析中，围手术期化疗的使用并未与罕见且对化疗敏感的腹膜后肉瘤亚型的生存改善相关联。然而，在解读这些发现时，必须考虑到选择偏倚的存在。

原文链接：

Perioperative Systemic Therapy in Rare, Chemosensitive Subtypes of Retroperitoneal Sarcoma: A Hospital-Based Propensity Score-Matched Analysis