原发性腹膜后肿瘤预后因素的meta分析

Prognostic factors of retroperitoneal neoplasms:a meta-analysis

目的探讨外科和辅助放疗腹膜后肿瘤的疗效和影响预后的因素。方法运用Meta分析对目前的临床治疗腹膜后肿瘤的研究和经验进行评价研究,从Cochrane library、Pub MED、EMBASE、CBM、万方、维普等数据库等收集文献。制定排除和纳入标准。运用STATA软件进行Meta分析。结果 10个研究分析结果显示:(1)腹膜后肿瘤手术联合放疗组患者局部控制率(LC)明显优于单纯手术组;(2)原发腹膜后肿瘤相比复发肿瘤有更好的术后总生存率;(3)低级别腹膜后肿瘤相比高级别肿瘤具有更好的术后总生存率;(4)病理类型,平滑肌肉瘤相比脂肪肉瘤降低了术后OS;(5)手术方式,全切相比部分切除或者活检具有更好的术后总生存率;(6)手术切缘,肿瘤切缘阴性或者镜下阳性相比肉眼阳性具有更好的术后OS。结论腹膜后肿瘤患者在严格完成手术的同时,可以根据相应情况选择合适的放疗方案进行治疗,以期提高患者的局部复发控制率。另外,早期诊断早期治疗,注重手术的完成质量和控制复发,有助于改善患者的总体生存率。

Objective This paper researches and evaluates the effect of surgery and adjuvant radiotherapy for PRT and the prognostic factors predictive of survival. Method Researchers use meta- analysis to assess the efficiency radiotherapy combined with surgery for PRT. Through searching from Cochrane Library, PubMed, Chinese Biomedical Database, Chinese Scienceand Technology Periodicals Database, China National Knowledge Infrastructure and Wanfang database, We worked out the selection criteria and exclusion criteria. We used the stata 12.0 to analysis the data. Results Research shows：l, the combination of radiotherapy and surgery for Local control is more effective than surgery alone ;2. primary PRT possess better OS than recurrent PRT;3. low grade PRT possess better OS compared with high grade PRT. 4. Among the two common types of PRT, leimyosarcoma reduces the OS compared with liposarcoma. 5. Complete surgery is more efficient than partial surgery or biopsy. 6. Negative margin or microscopically residual disease has better OS compared with macroscopically residual tumor. Conclusion From the study we draw the conclusion that while we performance the PRT with surgery, we could assess the status of patients and give appropriate radiotherapy, and this will be beneficial in local control rate. The sooner the diagnosis and treatment are, the better the outcome. In addition, sound quality of surgery and local control will also be beneficial of improving OS.