84例原发性腹膜后肉瘤患者外科处理分析

Surgical treatment analysis of 84 primary retroperitoneal soft-tissue sarcomas

目的 探讨原发性腹膜后肉瘤的临床处理 ,分析影响其预后因素。方法 收集 84例原发性腹膜后肉瘤患者的临床资料 ,回顾性分析其预后情况。用Kaplan -Meier法估计生存曲线 ,对可能影响患者长期存活的临床 ,病理 ,治疗方法各因素行单因素分析。结果 分级对 5年生存率有显著性影响 (P <0 .0 1)。完全切除率为 5 9.6%,完全切除后 5年生存率和 5年无瘤生存率分别是 48.1%和 3 8.8%,部分切除或活检患者 5年生存率和 5年无瘤生存率均为 0 ,两者存在高度显著性差异 (P <0 .0 0 1)。结论 肿瘤分级和手术切除是否完全是影响腹膜后软组织肉瘤预后的重要因素。对复发病例仍应积极手术治疗。限制肿瘤的假囊不应认为是安全边缘。

Objective To investigate the clinical treatment of patients with primary retroperitoneal soft-tissue sarcomas(PRSTS)and analyze the prognostic variables.Methods A retrospective study was undertaken.The hospital records of 84 patients with PRSTS who underwent surgical treatment were reviewed.To investigate both overall and disease-free survival,Kaplan-Meier methods were used.A univariate analysis was used to identify the main clinical pathologic and treatment-related factors affecting long-term survival.Results Grade influenced 5-year survival significantly(P< 0.01). Fifty patients (59.6%)underwent radical surgery.The 5-year survival and 5-year disease-free survival were 48.1% and 38.8%,respectively;otherwise,thirty-four patients underwent partial esection or biospy only,the 5-year survival and 5-year disease-free survival were zero,there were significant difference between them(P<0.001).Conclusion Tumor grade and gross surgical margins significantly affected prognosis.Pseudocapsule which restricted tumors should not be regarded as safe margin. [