腹膜后脂肪肉瘤完整切除后短期复发的影响因素分析

Analysis of influence factors for short-term recurrence of retroperitoneal liposarcoma after complete resection

目的探讨腹膜后脂肪肉瘤经外科手术完整切除后短期复发的影响因素。方法回顾性分析2000年1月至2020年1月在解放军总医院第一医学中心普通外科行腹膜后脂肪肉瘤切除术的91例患者的临床和病理学资料。男性60例,女性31例,年龄(52.1±9.9)岁(范围:30~84岁)。将完整切除后12个月内发生的肿瘤复发定义为短期复发,超过12个月发生的肿瘤复发定义为非短期复发。对腹膜后脂肪肉瘤完整切除后短期复发的影响因素进行分析,组间比较采用t检验、秩和检验、χ^(2)检验和Fisher确切概率法,多因素分析采用Logistic回归分析,以Kaplan-Meier曲线计算无复发生存时间,Log-rank检验进行组间比较。结果91例患者中,42例为短期复发,49例为非短期复发。单因素分析结果显示,肿瘤形态不规则、多种病理学亚型、病理评分>3分、多原发肿瘤是腹膜后脂肪肉瘤完整切除后短期复发的影响因素(χ^(2)值为4.422~7.773,P值均<0.05)。多因素分析结果显示,多原发肿瘤是腹膜后脂肪肉瘤完整切除后短期复发的独立影响因素(OR=2.918,95%CI:1.127~7.556,P=0.027)。多原发肿瘤患者的中位无复发生存时间短于单发肿瘤患者(6个月比9个月,P=0.028)。结论多原发肿瘤是腹膜后脂肪肉瘤完整切除后短期复发的独立影响因素。此类患者术后应增加随访次数,缩短随访的时间间隔。

Objective To examine the influence factors of short-term recurrence after complete surgical resection of retroperitoneal liposarcoma.Methods The clinicopathological data of retroperitoneal liposarcoma at Department of General Surgery,the First Medical Center,People′s Liberation Army General Hospital from January 2000 to January 2020 were retrospectively analyzed.There were 60 males and 31 females,aged(52.1±9.9)years(range:30 to 84 years).Tumor recurrence within 12 months after complete resection was defined as short-term recurrence,and tumor recurrence more than 12 months was defined as non-short-term recurrence.The t test,rank-sum test,χ^(2) test and Fisher exact test were conducted for inter-group comparison.Logistic regression analysis was used to analyze the independent influence factors for the short-term recurrence of retroperitoneal liposarcoma after complete resection.The Kaplan-Meier curve was used to calculate the recurrence-free survival,and the Log-rank test was adopted for the comparison between the groups.Results The univariate analysis results showed that irregular tumor morphology,multiple pathological subtypes,pathological scores>3,and multiple primary tumors are influence factors for short-term recurrence after complete resection of retroperitoneal liposarcoma(χ^(2):4.422 to 7.773,all P<0.05).Regression analysis of the above risk factors showed that multiple primary tumors was the independent risk factor(OR=2.918,95%CI:1.127 to 7.556,P=0.027).In the short-term recurrence group,Kaplan-Meier curve analysis showed that patients with multiple primary tumors had a shorter median recurrence time than patients with unifocal tumor(6 months vs.9 months,P=0.028).Conclusions Multiple primary tumor is an independent risk factor for short-term recurrence after complete resection of retroperitoneal liposarcoma.It suggests that the frequency of follow-up after surgery should be increased for such patients.