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腹膜后软组织肉瘤:117例原发性和复发性疾病的预后与治疗

Retroperitoneal soft tissue sarcomas: prognosis and treatment of primary and recurrent disease in 117 patients.

作者信息

Alldinger Ingo, Yang Qin, Pilarsky Christian, Saeger Hans-Detlev, Knoefel Wolfram T, Peiper Matthias

机构信息

Department of Visceral-, Thoracic- and Vascular Surgery, University Hospital Dresden, Fetscherstr. 74, D-01307 Dresden, Germany.

出版信息

Anticancer Res. 2006 Mar-Apr;26(2B):1577-81.

Abstract

BACKGROUND

The objective of this study was to define prognostic factors for patients with primary soft tissue sarcomas (STS) arising from the retroperitoneum.

PATIENTS AND METHODS

One hundred and seventeen consecutive patients, resected in our institutions between July 1972 and November 2002, were reviewed.

RESULTS

The prognostic factors predicting survival were incomplete resection, a tumor of high grade (G3), metastases to lymph nodes and distant metastasis. Patients with a malignant fibrous histiocytoma (MFH) or a malignant peripheral nerve sheath tumor (MPNST) had a worse prognosis than those patients with other tumors. The prognostic factors predicting local recurrence were incomplete resection and high grade (G3). The prognostic factors predicting metastasis were incomplete resection, lymph node metastasis at the time of the resection of the primary tumor and tumor histology.

CONCLUSION

Since only complete tumor resection offers a chance for cure, it is mandatory, and local control remains the most significant challenge in the management of retroperitoneal sarcomas. Other therapies can support surgical treatment, depending on the tumor localization and histological entity. The management of patients with a STS should be provided by a specialized team of surgeons, oncologists and radiotherapists, and patients should be enrolled in a treatment study whenever possible.

摘要

背景

本研究的目的是确定原发性腹膜后软组织肉瘤(STS)患者的预后因素。

患者与方法

回顾了1972年7月至2002年11月间在我们机构接受手术切除的117例连续患者。

结果

预测生存的预后因素包括切除不完全、高级别肿瘤(G3)、淋巴结转移和远处转移。患有恶性纤维组织细胞瘤(MFH)或恶性外周神经鞘瘤(MPNST)的患者比患有其他肿瘤的患者预后更差。预测局部复发的预后因素是切除不完全和高级别(G3)。预测转移的预后因素是切除不完全、原发性肿瘤切除时的淋巴结转移和肿瘤组织学类型。

结论

由于只有完整切除肿瘤才有治愈的机会,因此完整切除是必需的,而局部控制仍然是腹膜后肉瘤治疗中最重大的挑战。根据肿瘤的部位和组织学类型,其他治疗方法可辅助手术治疗。STS患者的治疗应由外科医生、肿瘤学家和放射治疗师组成的专业团队进行,并且只要有可能,患者应参加治疗研究。

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