93例包含脊索瘤的双原发恶性肿瘤临床分析
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摘要
为研究包含脊索瘤的双原发恶性肿瘤的临床特征及预后,评估生存相关的预后因素,通过回顾性分析2004～2015年SEER数据库中临床数据的方法研究了93例合并脊索瘤的双原发恶性肿瘤患者的临床资料。结果表明:93例病例中,双原发脊索瘤的发病率为10. 7%,高发的其他原发恶性肿瘤(非脊索瘤)为:前列腺癌、恶性黑色素瘤、甲状腺癌;脊索瘤好发部位为骨盆、骶尾骨、脊椎、颅骨; A组中双原发肿瘤中位间隔时间为28个月(0～88个月),B组双原发肿瘤中位间隔时间为48个月(0～434个月),两组间隔时间差异有统计学意义(P=0. 009);合并脊索瘤的双原发恶性肿瘤多发于老年男性(男∶女=1. 74∶1),异时瘤组多见(3. 43∶1),同时瘤组(C组)及异时瘤组(D组)在年龄、种族、N、M分期等方面差异无统计学意义(P>0. 05)。在性别、T分期、手术与否等方面差异有统计学意义(P≤0. 05);异时瘤组(D组)及手术组5年生存率、中位生存期较佳(P <0. 05)。可见在包含脊索瘤的双原发恶性肿瘤中,最高发的其他恶性肿瘤为前列腺癌,脊索瘤更好发于骨盆及骶尾部,异时瘤组(D组)及手术组的预后更好。
In order to study the clinical features and prognosis of double primary malignant tumors including chordoma,and to evaluate survival-related prognostic factors,Clinical data in the SEER database from 2004 to2015 was used to investigate the clinical data of 93 patients with double primary malignant tumors with chordoma.The results show that in 93 cases,the incidence of double primary chordoma is 10. 7%,and other primary malignant tumors( non-chondroma) were prostate cancer,malignant melanoma,thyroid cancer; The prediletion sites of chordoma were pelvis,appendix,spine,skull; The median interval between the two primary tumors in group A was 28 months( 0 ～ 88 months),and the median interval between the two primary tumors in group B was 48 months( 0 ～ 434 months). The difference between the two groups was statistically significant( P = 0. 009); Double primary malignant chordoma Tumors were more common in older men( male∶ female = 1. 74∶ 1),the metachronous tumor group( 3. 43∶ 1),and Simultaneous dual primary malignant tumor group( group C) and Metachronous double primary malignant tumor group( group D) were no significant difference in age,ethnicity,N,M staging( P > 0. 05),and significant difference in gender,T stage,surgery or not( P≤0. 05); the group D and operation group were better in the 5-year survival rate and median survival time( P < 0. 05). It is concluded that in the double primary malignant tumors involving chordoma,the highest incidence of the other malignant tumors and chordoma's sites are prostate cancer and pelvis and appendix respectively,and the prognosis is better in the metachronous tumor group( group D) and the surgery group.
In order to study the clinical features and prognosis of double primary malignant tumors including chordoma,and to evaluate survival-related prognostic factors,Clinical data in the SEER database from 2004 to2015 was used to investigate the clinical data of 93 patients with double primary malignant tumors with chordoma.The results show that in 93 cases,the incidence of double primary chordoma is 10. 7%,and other primary malignant tumors( non-chondroma) were prostate cancer,malignant melanoma,thyroid cancer; The prediletion sites of chordoma were pelvis,appendix,spine,skull; The median interval between the two primary tumors in group A was 28 months( 0 ～ 88 months),and the median interval between the two primary tumors in group B was 48 months( 0 ～ 434 months). The difference between the two groups was statistically significant( P = 0. 009); Double primary malignant chordoma Tumors were more common in older men( male∶ female = 1. 74∶ 1),the metachronous tumor group( 3. 43∶ 1),and Simultaneous dual primary malignant tumor group( group C) and Metachronous double primary malignant tumor group( group D) were no significant difference in age,ethnicity,N,M staging( P > 0. 05),and significant difference in gender,T stage,surgery or not( P≤0. 05); the group D and operation group were better in the 5-year survival rate and median survival time( P < 0. 05). It is concluded that in the double primary malignant tumors involving chordoma,the highest incidence of the other malignant tumors and chordoma's sites are prostate cancer and pelvis and appendix respectively,and the prognosis is better in the metachronous tumor group( group D) and the surgery group.
引文
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19付金金,黄载伟,林英豪,等.39例多原发结直肠癌的临床研究[J].南方医科大学学报,2013,33(4):578-581Fu Jinjin,Huang Zaiwei,Lin Yinghao,et al.Clinical analysis of 39cases of multiple primary colorectal carcinoma[J].Journal of Southern Medical University,2013,33(4):578-581
20 Kim B K,Oh S J,Song J Y,et al.Clinical characteristics and prognosis associated with multiple primary cancers in breast cancer patients[J].Journal of Breast Cancer,2018,21(1):62-69
21 Kim D H,Kim S M,Choi M G,et al.Multiple primary malignancies in patients with multiple early gastric cancer[J].Journal of Gastric Cancer,2017,17(2):154-161
22 Li F,Zhong W Z,Niu F Y,et al.Multiple primary malignancies involving lung cancer[J].BMC Cancer,2015(15):696-701
2 Sarabia-Estrada R,Ruiz-Valls A,Shah S R,et al.Effects of primary and recurrent sacral chordoma on the motor and nociceptive function of hindlimbs in rats:An orthotopic spine model[J].Journal of Neurosurgery.Spine,2017,27(2):215-226
3 Carey K,Bestic J,Attia S,et al.Diffuse skeletal muscle metastases from sacral chordoma[J].Skeletal Radiology,2014,43(7):985-989
4 Tori M,Shimo T,Yoshidome K.Novel operative approach to double primary cancers of the breast and thyroid and its effects on cosmesis and the accuracy of follow-up examinations[J].Asian Journal of Endoscopic Surgery,2018,11(2):185-188
5 Moertel C G,Dockerty M B,Baggenstoss A H.Multiple primary malignant neoplasms.II.tumors of different tissues or organs[J].Cancer,1961,14(5):231-237
6 Moschetti I,Cinquini M,Lambertini M,et al.Follow-up strategies for women treated for early breast cancer[J].The Cochrane Database of Systematic Reviews,2016(5):CD001768
7 Fornetti J,Welm A L,Stewart S A.Understanding the bone in cancer metastasis[J].Journal of Bone and Mineral Research:the Official Journal of the American Society for Bone and Mineral Research,2018,33(12):2099-2113
8 Smith Z,Girard N,Hansford B G.Multifocal metastatic chordoma to the soft tissues of the fingertips:A case report including sonographic features and a review of the literature[J].Skeletal Radiology,2018,47(3):401-406
9 Imai R,Kamada T,Araki N,et al.Carbon ion radiation therapy for unresectable sacral chordoma:An analysis of 188 cases[J].International Journal of Radiation Oncology,Biology,Physics,2016,95(1):322-327
10 Pennicooke B,Laufer I,Sahgal A,et al.Safety and local control of radiation therapy for chordoma of the spine and sacrum:a systematic review[J].Spine(Phila Pa 1976),2016,41(S20):186-192
11 Yin P,Mao N,Zhao C,et al.A triple-classification radiomics model for the differentiation of primary chordoma,giant cell tumor,and metastatic tumor of sacrum based on T2-weighted and contrast-enhanced T1-weighted MRI[J].International Society for Magnetic Resonance in Medicine,2019,49(3):752-759
12 Samji K,Alrashed A,Shabana W M,et al.Comparison of highresolution T1W 3D GRE(LAVA)with 2-point dixonfat/water separation(FLEX)to T1W fast spin echo(FSE)in prostate cancer(PCa)[J].Clinical Imaging,2016,40(3):407-413
13 Chambers K J,Lin D T,Meier J,et al.Incidence and survival patterns of cranial chordoma in the United States[J].The Laryngoscope,2014,124(5):1097-1102
14王海艳,吴永芳,许春伟,等.脊索瘤2例临床病理特征并文献复习[J].临床与病理杂志,2015,35(6):995-999Wang Hanyan,Wu Yongfang,Xu Chunwei,et al.Two case of chordoma with clinicopathological features of and literature review[J].Journal of Clinical and Pathological Research,2015,35(6):995-999
15 Lauer S R,Edgar M A,Gardner J M,et al.Soft tissue chordomas:a clinicopathologic analysis of 11 cases[J].The American Journal of Surgical Pathology,2013,37(5):719-726
16 Denaro L,Berton A,Ciuffreda M,et al.Surgical management of chordoma:A systematic review[J].The Journal of Spinal Cord Medicine,2018,14(1):1-16
17 Wu A,He S,Li J,et al.Colorectal cancer in cases of multiple primary cancers:clinical features of 59 cases and point mutation analyses[J].Oncology Letters,2017,13(6):4720-4726
18 Sanusi O,Arnaout O,Rahme R J,et al.Surgical resection and adjuvant radiation therapy in the treatment of skull base chordomas[J].World Neurosurgery,2018,115:13-21
19付金金,黄载伟,林英豪,等.39例多原发结直肠癌的临床研究[J].南方医科大学学报,2013,33(4):578-581Fu Jinjin,Huang Zaiwei,Lin Yinghao,et al.Clinical analysis of 39cases of multiple primary colorectal carcinoma[J].Journal of Southern Medical University,2013,33(4):578-581
20 Kim B K,Oh S J,Song J Y,et al.Clinical characteristics and prognosis associated with multiple primary cancers in breast cancer patients[J].Journal of Breast Cancer,2018,21(1):62-69
21 Kim D H,Kim S M,Choi M G,et al.Multiple primary malignancies in patients with multiple early gastric cancer[J].Journal of Gastric Cancer,2017,17(2):154-161
22 Li F,Zhong W Z,Niu F Y,et al.Multiple primary malignancies involving lung cancer[J].BMC Cancer,2015(15):696-701