原发性和复发性腹膜后软组织肉瘤：影响生存的预后因素。

Primary and recurrent retroperitoneal soft tissue sarcoma: prognostic factors affecting survival.

作者信息

Chiappa Antonio, Zbar Andrew P, Bertani Emilio, Biffi Roberto, Luca Fabrizio, Crotti Cristiano, Testori Alessandro, Lazzaro Gianluca, De Pas Tommaso, Pace Ugo, Andreoni Bruno

机构信息

Department of General Surgery, European Institute of Oncology, University of Milano, Milan, Italy.

出版信息

J Surg Oncol. 2006 May 1;93(6):456-63. doi: 10.1002/jso.20446.

DOI:10.1002/jso.20446

PMID:16615149

Abstract

BACKGROUND AND OBJECTIVES

To analyze treatment and survival in 34 patients (28 resected) with primary or recurrent retroperitoneal sarcoma (RPS).

METHODS

Between July 1994 and January 2001, 34 patients (15M, 19F; mean age: 56 years, range: 25-77) were evaluated. Complete resection was defined as removal of gross tumor with histologically confirmed clear resection margins.

RESULTS

Twenty-eight out of 34 patients (82%) (15 were affected by primary RPS, and 13 by recurrent RPS), underwent surgical exploration. Twenty-three patients had a grossly and microscopically complete resection, (3 having a grossly incomplete resection and 2 patients with a grossly complete resection having histologically involved resection margins). Twenty-one out of 28 patients (75%) underwent removal of contiguous intra-abdominal organs. Preoperative mortality was nil, and morbidity occurred in six cases only (21%). High tumor grade results a significant variable for a worse survival in all 28 patients (100% 5 years survival for low grade vs. 0% for high grade; P = 0.0004). Amongst completely resected patients, only histologic grade and peroperative blood transfusions affected disease-free survival (P = 0.04 and P = 0.05, respectively).

CONCLUSIONS

An aggressive surgical approach in both primary and recurrent RPS is associated with long-term survival.

摘要

背景与目的

分析34例原发性或复发性腹膜后肉瘤（RPS）患者（28例接受手术切除）的治疗及生存情况。

方法

1994年7月至2001年1月期间，对34例患者（15例男性，19例女性；平均年龄：56岁，范围：25 - 77岁）进行了评估。完整切除定义为切除大体肿瘤且组织学证实切缘阴性。

结果

34例患者中有28例（82%）（15例为原发性RPS，13例为复发性RPS）接受了手术探查。23例患者实现了大体和显微镜下的完整切除（3例大体切除不完整，2例大体切除完整但组织学切缘受累）。28例患者中有21例（75%）接受了毗邻腹腔内器官的切除。术前死亡率为零，仅6例（21%）出现并发症。肿瘤高分级是所有28例患者生存较差的显著变量（低分级5年生存率为100%，高分级为0%；P = 0.0004）。在完全切除的患者中，只有组织学分级和术中输血影响无病生存期（分别为P = 0.04和P = 0.05）。