The Journal of the Korean bone and joint tumor society (대한골관절종양학회지)

The Korean Musculoskeletal Tumor Society (대한근골격종양학회)
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Prognostic Factors in Liposarcomas: A Retrospective Study of 52 Patients

지방육종의 예후 인자: 52예 후향적 연구

  • Chung, Yang-Guk (Department of Orthopedic Surgery, College of Medicine, The Catholic University of Korea) ;
  • Kang, Yong-Koo (Department of Orthopedic Surgery, College of Medicine, The Catholic University of Korea) ;
  • Bahk, Won-Jong (Department of Orthopedic Surgery, College of Medicine, The Catholic University of Korea) ;
  • Rhee, Seung-Koo (Department of Orthopedic Surgery, College of Medicine, The Catholic University of Korea) ;
  • Lee, An-Hi (Department of Pathology, College of Medicine, The Catholic University of Korea) ;
  • Park, Jung-Mee (Department of Radiology, College of Medicine, The Catholic University of Korea) ;
  • Kim, Min-Woo (Department of Orthopedic Surgery, College of Medicine, The Catholic University of Korea)
  • 정양국 (가톨릭대학교 의과대학 정형외과학교실) ;
  • 강용구 (가톨릭대학교 의과대학 정형외과학교실) ;
  • 박원종 (가톨릭대학교 의과대학 정형외과학교실) ;
  • 이승구 (가톨릭대학교 의과대학 정형외과학교실) ;
  • 이안희 (가톨릭대학교 의과대학 병리학교실) ;
  • 박정미 (가톨릭대학교 의과대학 영상의학교실) ;
  • 김민우 (가톨릭대학교 의과대학 정형외과학교실)
  • Received : 2010.04.03
  • Accepted : 2010.05.30
  • Published : 2010.06.30
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Abstract

Purpose: To investigate prognostic factors influencing on local recurrence, distant metastasis and event-free survival of liposarcomas. Materials and Methods: Fifty-two patients managed for liposarcomas since 1993 were analyzed respectively in the view of prognostic influence of patient age, tumor size, location, histologic type, histologic grade, resection type, surgical margin, chemotherapy and radiation therapy on local recurrence, distant metastasis and event-free survival. The mean follow up period was 39 months. The univariate and multivariate regression analysis were performed for statistical evaluation. Results: The local recurrences occurred in 11 patients (21.2%) and distant metastasis in 4 patients (8%), Event-free survival rate at 4 year follow up was 67%. In univariate analysis, histologic grade, surgical margin, chemotherapy and radiation therapy were significant prognostic factors on local recurrence (p<0.05). However, histologic grade lost its significance in muitivariate analysis. Trunk location revealed higher rate of distant metastasis than extremity location. In univariate analysis on event-free survival. histologic grade and chemotherapy were significant factors (p<0.05). No factor remained significant in multivariate analysis. Conclusion: Considering selection bias, positive surgical margin was negative prognostic factor on local recurrence. Liposarcomas arisen in trunk revealed higher rate of distant metastasis. There was no independent prognostic factor on event-free survival of patients with liposarcomas.

목적: 지방육종의 국소재발과 원격전이 및 무병생존율에 영향을 미치는 예후인자들에 대해 알아보고자 하였다. 대상 및 방법: 1993년 이후 치료받은 52명의 지방육종 환자들을 대상으로 진단시 연령, 종양의 크기, 발생 부위, 조직학적 유형, 조직학적 악성도, 절제 유형, 수술적 절제연, 항암화학요법 및 방사선 치료가 국소재발, 원격 전이 그리고 무병생존율에 미치는 영향을 분석하였다. 평균 추시기간은 39개월이었고 통계적 분석에는 단일변수 및 다중변수 회귀분석을 이용하였다. 결과: 국소 재발이 11예(21.2%)에서 발생하였으며 원격전이는 4예(8%)에서 발생하였다. 지속적 무병생존율은 술 후 4년에 67%였다. 단일변수 분석에서 조직학적 악성도, 절제연, 항암화학요법, 방사선 치료가 국소재발과 관련이 있었으나(p<0.05) 다중변수 분석에서는 절제연과 항암화학요법, 방사선 치료가 불량한 예후인자로 나타났다. 종양이 체간에서 발생한 경우 통계적으로 유의하게 원격 전이율이 높았다(p<0.05). 무병생존율에 대한 단일변수 분석에서는 조직학적 악성도 및 항암화학요법이 유의한 차이를 보였으나(p<0.05) 다중변수 분석에서는 유의한 인자가 없었다. 결론: 선택오차를 고려할 때 절제연 양성이 국소재발의 불량한 예후인자였으며 종양이 체간에서 발생한 경우 원격 전이율이 높았다. 무병생존율과 관련하여서는 유의한 인자가 없었다.

Keywords

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