目的 · 分析骨盆软骨肉瘤临床特点和预后因素,为临床诊治提供参考。方法 · 收集73 例软骨肉瘤患者病例资料,其中24 例为骨盆软骨肉瘤。总结骨盆软骨肉瘤的临床特点,分析其预后因素。结果 · 24 例骨盆软骨肉瘤患者中,男女比1.4:1,中位年龄 43.5 岁。按 Enneking 骨盆肿瘤分区,Ⅰ区 5 例,Ⅱ区 14 例,Ⅲ区 5 例;组织学分级为软骨肉瘤I 级的1 例,Ⅱ级 15 例,Ⅲ级 8 例;组织学类型为普通中央型 17 例,去分化型 3 例,继发型 2 例,黏液型、间质型各 1 例。24 例患者 3、5 和 10 年总生存率分别为 (82.2±8.1) %、( 77.3±8.9) %、( 52.4±12.1) %。骨盆软骨肉瘤手术切除后局部复发率 (83.3%) 高于其他部位(34.7%),差异有统计 学意义(P=0.000);最终接受截肢手术的比例(50.0%)也高于其他部位(20.4%),差异有统计学意义(P=0.000);但 2 组总生存时 间比较,差异无统计学意义(P=0.216)。 结论 · 骨盆软骨肉瘤局部复发率较高,更易导致截肢;术后较早复发,提示其预后不佳。
Objective · To summarize the clinical characteristics and prognostic factors of pelvic chondrosarcoma. Methods · A total of 73 cases of chondrosarcoma were collected, including 24 of pelvic. The clinical characteristics and prognostic factors of pelvic chondrosarcoma were analyzed by statistic methods. Results · The ratio of men to women was 1.4:1,and the median age is 43.5 years old. According to the classification of pelvic proposed by Enneking, there were 5 in region Ⅰ , 14 in region Ⅱ , and 5 in region Ⅲ . On histological review, 1 was grade 1, 15 were grade 2 ,and 8 were grade 3. The histologic types included 17 conventional, 3 dedifferentiated, 2 secondary, and 1 mesenchymal. The overall survival rates of pelvic chondrosarcoma were (82.2±8.1) %,(77.3±8.9) % and(52.4±12.1) % for 3, 5 and 10 years respectively. Local recurrence rate of pelvic chondrosarcoma (83.3%) was significantly higher than those of other sites (34.7%)(P=0.000), and the proportion of amputation was significantly higher than the other sites (50.0% vs 20.4%, P=0.000), but there was no significant difference in the overall survival between the two groups (P=0.216). Conclusion · Pelvic chondrosarcoma have a higher local recurrence rate than the other sites and is tend to result in amputation. Early local recurrence after surgery indicates poor prognosis.