脂肪肉瘤临床特征及预后相关因素分析

Clinical data analysis and long-term outcome of liposarcoma patients

目的分析和探讨脂肪肉瘤的临床特征、诊治方法及预后因素。方法收集2009—2019年间我院手术治疗的48例脂肪肉瘤患者的临床资料,单因素或Cox模型多因素分析预后影响因素。结果在45例获得随访患者中32例出现肿瘤复发(71%),发病年龄是唯一复发相关因素(P<0.05)。18例患者死亡(40%),中位生存期为8年,5、10年生存率分别为63%、47%。肿瘤位置、病理类型、手术方式与预后相关(P<0.05),但多因素分析中仅肿瘤位置是独立预后因素(P<0.05)。在32例复发患者中,中位生存期为6年,术后首次复发的时间和病理类型是预后相关因素(P<0.05),但多因素分析中仅首次术后复发时间是独立预后因素(P<0.05)。结论脂肪肉瘤较为罕见,临床表现不具有特异性。病理类型并不是独立的预后因素,而肿瘤位置和首次复发时间具有更加重要的预后价值。

Objective To analyze and explore the clinical manifestations,diagnostic methods,treatment and prognostic factors of liposarcoma.Methods The clinical data of 48 patients with liposarcoma between 2009 and 2019 were collected,and we analyzed the influence of potential prognostic factors with the univariate or Cox models multivariate analysis methods.Results Among the 45 patients with complete follow-up data,32 patients experienced tumor recurrence(71%),18 cases have died(40%).In all patients,we found that the patient’s age was the only significant correlation on recurrence(P<0.05).The median survival was 8 years.The 5-and 10-yearsOS rate were 63%and 47%,respectively.Tumor location,pathological type and operation mode were prognostic factors(P<0.05),but in Cox proportional hazard model only tumor location was found to be an independent prognostic factor of OS.In 32 patients with recurrence,the median survival was 6 years.Time of first postoperative recurrence and pathological type were prognostic factors(P<0.05),but time of first postoperative recurrence was found to be an independent prognostic factor in Cox models multivariate analysis method(P<0.05).Conclusions Liposarcomas are rare and have no specific clinical manifestations.We found that pathological type was not an independent prognostic factor,but tumor location and the time of first postoperative recurrence were found to be more important prognostic factors in patients with liposarcoma.