四肢骨肉瘤保肢治疗与预后影响因素分析

目的探究四肢骨肉瘤保肢治疗与预后的危险因素。方法 89例四肢骨肉瘤患者行保肢治疗后随访3年,依据3年预后结局分为生存组(71例)与死亡组(18例),比较两组患者临床特征,分析死亡的相关因素,将相关因素代入Cox比例风险模型分析危险因素。结果生存组及死亡组四肢骨肉瘤患者Enneking分期及是否术后肺转移、治疗后病理性骨折、术前乳酸脱氢酶升高、完成化疗情况比较,差异均有统计学意义(P﹤0.05)。术后出现肺转移、未完成化疗及Enneking分期为Ⅱ期或Ⅲ期为四肢骨肉瘤保肢治疗后3年内死亡的危险因素(P﹤0.05)。结论尽早确诊、尽早治疗、积极预防病理性骨折、完成规范化疗及预防肺转移的发生能够辅助提高四肢骨肉瘤患者保肢治疗后的生存率。

Limb salvage therapy and prognostic factors for limb osteosarcoma

Objective To study the limb salvage therapy and prognostic factors for limb osteosarcoma.Method A total of 89 patients underwent limb salvage therapy for limb osteosarcoma were followed up for 3 years and were divided into survival group(71 cases)and death group(18 cases)based on the results of follow-up.The clinical characteristics were compared between the two groups,related factors of death analyzed and risk factors analyzed with factors in Cox proportional hazards model.Result There were significant differences for Enneking staging,postoperative pulmonary metastasis,pathological fracture after treatment,preoperative lactate dehydrogenase elevation and completion of chemotherapy between the two groups(P<0.05);postoperative lung metastasis,mcompletion of chemotherapy and Ennekmg stageⅡorⅢwere the risk factors for death within 3 years after limb salvage treatment for limb osteosarcoma(P<0.05).Conclusion Early diagnosis and treatment,active prevention of pathological fractures,completion of standard chemotherapy and prevention of pulmonary metastasis can help improve the survival rate of patients with limb salvage osteosarcoma.