原发性腹膜后软组织肉瘤预后因素的COX模型分析

SURVIVAL ANALYSIS OF PRIMARY RETROPERITONEAL SOFT-TISSUE SARCOMAS BY COX REGRESSION MODEL

自１９６４年４月至１９９２年４月，我院共收治原发性腹膜后软组织肉瘤１４８例，总的２、５、１０年生存率为５７，８％、２２．４％和１０．７％。本文运用ＣＯＸ模型，对可能影响本病预后的有关因素，分别作单因素及多因素分析。分析结果表明肿瘤有无全切除，是影响本病预后的最重要因素。因此，我们主张在明确本病诊断后，尽可能完全切除肿瘤，对术后复发者，也要争取再次、多次手术切除，术后酌情辅加放疗。

Primary retroperitoneal soft tissue sarcoma(PRSS) is a heteroge- nous groap of rate and capricious mesenchymal malignant tumors. This paper presented the first time application of Cox regresaion model in survival analysis of PRSS in.China. From Apr. 1964 to Apr. 1994, 148 patients with PRSS admitted to and treated in our ho- spital. The total 5-and 10-year survival rates were 22.4% and 10.7%. Using Cox model, a univariate analysis of PRSS was performed. Out of 28 factors, significant factors were the type of operation, clinical staging, histological grade, first operation, postoperative recurrence, distant metastasis, quantity of hemoglobin, adjuvant radiothrapy, how many hours it was taken to do operation, and course of disease. Using a multivariate analysis of Cox model, the order of significant factors were the type of operation, clinical sta- ging, and adjuant radiotherapy and etc. The survival analysis of PRSS by Cox regres- sion model showed the type of operation is the most important factor influenced the prognosis of PRSS. So we advocate that when diagnosis of PRSS was established, complete resection should be performed, second operation or multiple operations should be done for these patients of postoperative recurrence. After operation adjuvant radia- tions is,suggested.