Table_2_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

尽管临床医生及四肢骨与软组织（EBST）疾病的患者对保肢手术（LSS）日益关注，鉴于手术对外观和功能的损害微乎其微，然而，关于LSS是否能够改善患者预后的大规模人群研究仍显不足。研究目的本研究的目的是比较接受LSS和截肢治疗的EBST肉瘤患者的生存情况。研究方法为了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例经组织学诊断的骨肉瘤患者和24,378例经组织学诊断的软组织肉瘤患者。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，分析了总生存期（OS）、癌症特异性生存期（CSS）和非肉瘤生存期（NSS）。研究结果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有增加作用。里程碑分析进一步表明，肉瘤幸存者的生存情况