摘要
目的总结原发性腹膜后肿瘤(PRPT)临床诊断治疗经验,分析影响PRPT手术效果和预后的因素。方法同顾性分析解放军总医院600例PRPT的临床诊断、手术治疗、疗效和预后。结果600例PRPT中546例行手术,肿瘤全部切除326例(占59.7%),肿瘤部分切除192例,肿瘤未切除取活检28例。同时行联合脏器切除手术113例(占20.7%)。PRPT完全切除组的1、3、5年生存率分别为:90.5%、73.2%、53.6%,恶性PRPT部分切除组的1、3、5年牛存率分别为:70.6%、32.0%、5.7%(P<0.01)。Cox多因素回归分析显示:PRPT的局部复发、生存期与(1)肿瘤是否完伞切除;(2)肿瘤大小;(3)肿瘤细胞的分化程度明显相关。结论充分做好PRPT手术前准备,提高肿瘤完全切除率,是降低PRPT肿瘤复发,提高生存率和预后的关键。
Objective: To summarize the experience of management for primary retroperitoneal tumor (PRPT) and to analyze the factors influencing the outcome after operation. Methods: The data of 600 cases of PRPT in General Hospital of PLA were reviewed retrospectively. Results: Of 600 cases of PRPT, 546 were surgically treated. Among theme 369 were malignant and 177 benign. 366 cases were followed up for 1 month to 15 years. The 1-years 3-year, and 5-year survival rate in the patients subject to complete resection was 90.5%, 73.2% and 53.6%, respectively, and that in incomplete resection patients was 70.6%, 32.0%, 5.7% respectively (P〈0.01). The Cox multi-various regression analysis revealed showed completeness of tumor resection, sex and histologic type were associated closely with local recurrence. Conclusion: Sufficient preoperative preparation and complete tumor resection play important roles for reducing recurrence and improving survival.