腹膜后脂肪肉瘤的生物学特性及其诊断和治疗

Retroperitoneal liposarcoma:a study of biological characteristics and strategy of diagnosis and treatment

目的探讨腹膜后脂肪肉瘤生物学行为及诊断与治疗的有关问题。方法回顾性分析1970-2005年中国医科大学附属第一医院收治的32例(共接受手术43例次)原发及复发腹膜后脂肪肉瘤病人的临床和病理资料。结果该病主要临床表现是腹胀、腹部包块进行性增大。复发病例较原发病例生物学行为差,肿瘤侵袭力强,组织学亚型恶性程度高,手术完全切除率低。多次复发者复发间期逐渐缩短。难治性大出血是术后主要且致命的并发症。结论腹膜后脂肪肉瘤术后易复发,很少转移,手术切除是最有效的治疗手段。完全切除者复发间期长,控制术中出血是减少术后死亡的关键。放、化疗对腹膜后脂肪肉瘤的作用有限。

Objective To study the biological behavior and strategy of diagnosis and treatment of retroperitoneal liposarcoma. Methods The clinical and pathological data of 32 patients with primary and recurrent retroperitoneal liposarcoma admitted in the First Affiliated Hospital of China Medical University between 1970 and 2005 （ received 43 operations aggregately） were analyzed retrospectively. Results The most common clinical manifestations were abdominal distension, growing and palpable abdominal mass. Compared with primary cases, recurrent cases had the following characteristics：the worse biological behaviors, stronger tumor invasive power, higher grade of histologic subtypes and the less complete resection. The interval without tumor burden turned shorter after multiple recurrences. Refractory hemorrhage was the major and lethal complication after operation. Conclusion Although recurrence is common after resection, surgical resection is still the most effective treatment for retroperitoneal liposarcoma. The more complete resection patients receive, the longer interval without tumor burden patients have. Avoiding refractory hemorrhage is the key point to diminish mortality after operation. Radiotherapy and chemotherapy have limited effect on retroperitoneal liposarcoma.