联合脏器切除术治疗腹膜后脂肪肉瘤的疗效分析

Efficacy of Combined Organs Resection in Retroperitoneal Liposarcoma

目的:探讨腹膜后脂肪肉瘤(retroperitoneal liposarcoma,RPLS)的临床特点及联合脏器切除术在RPLS治疗中的价值。方法:回顾分析1999年4月—2009年5月复旦大学附属中山医院经病理证实的58例RPLS患者的临床资料。结果:58例患者,共完成手术82例次,其中31例次为首次手术,51例次为复发再次手术。完整切除率为70.7%,首次手术完整切除率(87.1%)显著高于复发再手术(60.8%),P=0.009。联合脏器切除32例次,联合脏器切除率为39.0%。单因素分析显示,肿瘤大小、病理类型、首次手术是否完整切除将影响患者无瘤生存时间;多因素分析显示仅肿瘤大小是肿瘤复发的因素。结论:联合脏器切除可提高RPLS的切除率,肿瘤大小是肿瘤复发的主要因素,病理类型影响患者总生存时间,而联合脏器切除、首次手术完整切除等因素对患者总生存时间无影响。

Objective：To explore the clinical features of retroperitoneal liposarcoma （RPLS） and the values of combined organs resection in the RPLS treatment. Methods：The clinical data of 58 patients with RPLS confirmed by pathology and hospitalized in Zhongshan Hospital, Fudan University from April 1999 to May 2009 were analyzed retrospectively. Results： A total of 82 surgeries were completed in these 58 patients, 31 of which were for primary cases, 51 cases for recurrent cases. The total com- plete resection rate was 70.7 %, and the complete surgical resection rate for the first surgery was 87.1%, which is significantly higher than that of the recurrent cases （60.8%）, P = 0. 009. Among them, 32 cases（39%） were performed combined organs resection. Results of univariate analysis suggested that the tumor-free survival time of patients was associated with tumor size, histological type and complete resection in the first surgery. Results of multivariate analysis suggested that tumor recurrence was only associated with tumor size. Conclusions： Combined organs resection can improve the complete resection rate of pa- tients with RPLS. The overall survival time of the patients is affected by pathological types; rather than the combined organs resection or complete resection in the first surgery.