ObjectiveTo systematically review the predictive value of ezrin expression in bone and soft tissue sarcomas.MethodsDatabases including PubMed, EMbase, The Cochrane Library (Issue 2, 2016), CNKI, CBM, VIP, and WanFang Data were searched to collect cohort studies about the prognostic value of ezrin expression in bone and soft tissue sarcomas from inception to May 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was performed by using RevMan 5.3 software.ResultsFinally, a total of 17 cohort studies, involving 1 460 patients were included. The results of meta-analysis showed that: the overall survival (HR=1.90, 95%CI 1.70 to 2.13, P<0.000 01), event-free survival (HR=2.42, 95%CI 1.53 to 3.84, P=0.0002), metastasis-free survival (HR=2.09, 95%CI 1.10 to 3.97, P=0.02) in the bone and soft tissue sarcomas patients with ezrin high expression were lower than patients with lower expression. The same results were also observed in subgroup analysis according to histologica type and ethnicity in overall survival.ConclusionEzrin high expression may be used as a predictive maker for poor prognosis in bone and soft tissue sarcomas. For the quantity and quality limitation of the included studies, this conclusion still needs to be further proved by performing more high quality studies.
Objective To compare the effectiveness of different treatment strategies after unplanned surgery for myxoid liposarcoma (MLS) and explore the clinical value of salvage therapy versus planned treatment following unplanned resection. Methods The clinical data of 37 MLS patients admitted between June 2014 and June 2024 who met the selection criteria were retrospectively analyzed. Patients were divided into three groups based on initial treatment status: the unplanned treatment group (group A, 14 cases, transferred after benign tumor excision without further treatment at external hospitals, presenting with local recurrence), the salvage planned treatment group (group B, 10 cases, transferred within 1 month after benign tumor excision at external hospitals), and the planned treatment group (group C, 13 cases, transferred without prior treatment or only after biopsy). No significant difference (P>0.05) was observed among the three groups in baseline characteristics including age, height, weight, and maximum preoperative tumor diameter. Tumor recurrence or metastasis time were recorded. Overall survival (OS) and disease-free survival (DFS) rates were calculated using the Kaplan-Meier method with intergroup comparisons. ResultsAll 37 patients were followed up 19-193 months (mean, 67.4 months). Group A exhibited higher tumor recurrence (28.6%) and metastasis rates (35.7%) than group B (10.0%, 10.0%) and group C (0, 23.1%), with significant differences in recurrence rates (P<0.05), no significant differences existed between groups B and C (P>0.05); metastasis rates showed no intergroup significance (P>0.05). Group A demonstrated lower 1-/3-/5-year DFS (71.4%, 42.9%, 21.4%) than group B (100%, 88.9%, 74.1%) and group C (92.3%, 83.9%, 71.9%), with significant differences (P<0.017), no significant difference existed between groups B and C (P>0.017); 3-/5-year OS showed no intergroup significance (P>0.05). Conclusion Patients with MLS should undergo standard extended resection and individualized adjuvant radiotherapy and chemotherapy as soon as possible after unplanned surgery to significantly reduce the local recurrence rate. In view of the high risk of extrapulmonary metastasis, a comprehensive preoperative assessment of metastasis is required.