Table_1_Impact of Limb Salvage on Prognosis of Patients Diagnosed With Extremity Bone and Soft Tissue Sarcomas.docx

BackgroundAlthough clinicians and patients with extremity bone and soft tissue (EBST) are increasingly interested in limb salvage surgery (LSS), because of the minimal damage to physical appearance and function, however, there is still a lack of large-scale population studies on whether LSS improves the prognosis of patients.PurposeThe aim of this study was to compare the survival of patients with EBST sarcomas after receiving LSS and amputation.MethodsTo conduct the population-based study, we identified 6,717 patients with a histologically diagnosed bone sarcoma and 24,378 patients with a histologically diagnosed soft tissue sarcoma from the Surveillance, Epidemiology, and End Results database. We analyzed overall survival (OS), cancer-specific survival (CSS), and non-sarcoma survival (NSS) using the Kaplan–Meier method, log-rank test or Gray test, Cox regression model, propensity score-matched analysis, and landmark analysis.ResultsLSS could improve the prognosis in patients with most EBST subtypes, except for Ewing sarcomas and MPNST. However, in the subgroup without distant metastases, limb salvage increased CSS only for patients with osteosarcoma, Ewing sarcoma, and leiomyosarcoma, as well as NSS for patients with chondrosarcoma and synovial sarcoma. Landmark analysis further demonstrated that sarcoma survivors surviving

背景尽管肢体骨与软组织（EBST）的临床医师和患者对保肢手术（LSS）的关注度日益增加，鉴于其对外观和功能的损害最小，然而，关于LSS是否能改善患者预后的大规模人群研究仍显不足。目的本研究旨在比较接受LSS和截肢的EBST肉瘤患者的生存率。方法为进行基于人群的研究，我们从监督、流行病学和结果数据库中确定了6,717名组织学诊断为骨肉瘤的患者和24,378名组织学诊断为软组织肉瘤的患者。我们采用Kaplan-Meier方法、log-rank检验或Gray检验、Cox回归模型、倾向得分匹配分析和里程碑分析来分析总生存期（OS）、癌症特异性生存期（CSS）和无肉瘤生存期（NSS）。结果LSS能够改善大多数EBST亚型患者的预后，但Ewing肉瘤和MPNST除外。然而，在无远处转移的亚组中，保肢手术仅对骨肉瘤、Ewing肉瘤和纤维肉瘤患者的CSS以及软骨肉瘤和滑膜肉瘤患者的NSS有所提升。里程碑分析进一步表明，肉瘤幸存者存活