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Prognostic impact of diagnostic and treatment delays in children with osteosarcoma.

骨肉瘤患儿诊断和治疗延迟的预后影响。

  • 影响因子:2.28
  • DOI:10.1002/pbc.28180
  • 作者列表:"Vasquez L","Silva J","Chavez S","Zapata A","Diaz R","Tarrillo F","Maza I","Sialer L","García J
  • 发表时间:2020-04-01
Abstract

BACKGROUND:The aim of this study is to evaluate the relationship between the latency to diagnosis (LD) and the time to completion of chemotherapy (TCC) with clinical outcomes in children with osteosarcoma. METHODS:We performed a retrospective analysis of all patients who received treatment for osteosarcoma in two tertiary centers in Peru from 2008 to 2015. All causes of delayed LD or TCC were evaluated. Overall survival (OS) and event-free-survival (EFS) were estimated and compared according to LD, TCC, and established clinical prognostic factors. RESULTS:One hundred and thirteen patients were included in the study. The median LD was 13.5 weeks (interquartile range, 10-18.5 weeks). No association was observed among clinical stage, tumor size, and LD. Delayed LD was not associated with a worse clinical outcome. Multivariate analysis confirmed that OS and EFS were significantly worse in cases of a delayed TCC (≥4 weeks), with hazard ratios of 2.70 (1.11-6.76, P = 0.003) and 1.13 (1.00-1.26, P = 0.016), respectively. Most delays in TCC (85%) were due to extramedical reasons (e.g., lack of available hospital beds). CONCLUSION:The LD did not seem to influence the EFS and OS in pediatric patients with osteosarcoma. However, a delay in TCC from any cause is independently associated with poor outcome in pediatric patients with osteosarcoma. Based on these results, further efforts may be needed to avoid treatment delays in patients with osteosarcoma in middle-income countries.

摘要

背景: 本研究的目的是评估骨肉瘤患儿诊断潜伏期 (LD) 和化疗完成时间 (TCC) 与临床结局之间的关系。 方法: 我们对 2008 年至 2015 年在秘鲁两个三级中心接受骨肉瘤治疗的所有患者进行了回顾性分析。评价了所有延迟LD或TCC的原因。根据LD、TCC和确定的临床预后因素估计和比较总生存率 (OS) 和无事件生存率 (EFS)。 结果: 研究纳入了 113 例患者。中位LD为 13.5 周 (四分位距,10-18.5 周)。未观察到临床分期、肿瘤大小和LD之间存在关联。延迟LD与较差的临床结局无关。多变量分析证实,延迟TCC (≥ 4 周) 病例的OS和EFS显著更差,风险比为 2.70 (1.11-6.76,P = 0.003) 和 1.13 (1.00-1.26,P = 0.016),分别。TCC的大多数延迟 (85%) 是由于医学外原因 (如缺乏可用的病床)。 结论: LD似乎不影响儿童骨肉瘤患者的EFS和OS。然而,任何原因导致的TCC延迟与骨肉瘤患儿的不良预后独立相关。基于这些结果,可能需要进一步努力避免中等收入国家骨肉瘤患者的治疗延误。

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发表时间:2020-03-01
DOI:10.1177/1078155219842277
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骨肿瘤方向

骨肿瘤是发生于骨骼或其附属组织的肿瘤。有良性,恶性之分,良性骨肿瘤易根治,预后良好,恶性骨肿瘤发展迅速,预后不佳,死亡率高。

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