腹膜后脂肪肉瘤患者首次外科切除后无进展生存期的影响因素及预后分析

Progression-free survival related factors and the prognosis after first surgical resection forretroperitoneal liposarcoma

目的探讨腹膜后脂肪肉瘤患者的首次外科治疗情况与无进展生存期影响因素及预后。方法回顾性分析1998-2016年郑州大学附属肿瘤医院普外科收治的经术后病理证实的74例腹膜后脂肪肉瘤患者的临床资料,分析腹膜后脂肪肉瘤患者在首次外科切除后无进展生存期的影响因素。结果首次接受外科切除的腹膜后脂肪肉瘤患者的无进展生存期与瘤内坏死(P<0.001)、瘤体分叶(P<0.001)、是否症状就诊(P=0.013)、肉眼R0切除(P=0.003)、远隔转移(P=0.028)、术后辅助化疗(P=0.006)及分化级别(P<0.001)均有关,与患者的性别、首诊年龄、侵犯周围脏器、瘤体长径、手术时间及是否联合脏器切除均无关(均P>0.05)。无进展生存期W24个月和>24个月患者的1、3、5年生存率分别为93.7%比94.7 ,90.5%比80.9%、58.4%比74.8%,差异无统计学意义(P=0.111)。首发病理分级(P<0.001)、症状就诊(P<0.001)、联合脏器切除(P=0.042)均影响患者的预后。结论腹膜后脂肪肉瘤患者的首次外科治疗影响其无进展生存期,但无进展生存期的长短与其预后无关。

Objective To investigate the effect of the first surgical treatment on progress ion-free survival (PFS) time of retroperitoneal liposarcoma and the prognosis.Methods We analyzed the clinical data of 74 cases of retroperitoneal liposarcoma from 1998 to 2016 in He'nan Cancer Hospital (Zhengzhou University Affiliated Tumor Hospital Department of General Surgery).Results The results demonstrated that progression-free survival time of the first surgical resection of retroperitoneal liposarcoma in patients related with tumor necrosis (P<0.001 ), lobulated tumor (P<0.001 ), symptoms (P=0.013), Ro resection (P=0.003 ), distant metastasis (P=0.028), postoperative chemotherapy (P=0.006) and tumor differentiation (P<0.001 ).Progression-free survival time was not correlated with gender, age of first diagnosis , the invasion of adjacent organs, tumor size, operation time and combined organ resection (all P>0.05).The rate of 1 -year ,3-year,5-year survival time attached to PFS W24 m and PFS>24 m were 93.7% vs.94.7 ,90.5% vs.80.9%,58.4% vs.74.8%(P=0.111).Conclusion The first attempt of radical resection determines progression-free survival of retroperitoneal liposarcoma, however, patientsz PFS was not related with their overall survival.