Gockel I, Oberholzer K, Gönner U, Mantai S, Junginger T
Klinik für Allgemein- und Abdominalchirurgie der Johannes-Gutenberg-Universität Mainz.
Zentralbl Chir. 2006 Jun;131(3):223-9. doi: 10.1055/s-2006-933466.
Due to the fact that there are no distinct anatomical compartments, retroperitoneal sarcomas are moreover diagnosed with evidence of large tumors and infiltration of adjacent organs. In spite of improvement of the diagnostic facilities and surgical techniques, quite frequently local recurrences with unfavourable prognosis turn up even after complete removal. It was the aim of this study to analyze diagnosis, therapy and long-term prognosis in patients with retroperitoneal sarcomas over a period of 10 years.
Between January 1995 and January 2005, 379 patients underwent surgery for a primary retroperitoneal tumor at our clinic. Among the 67 (17.1 %) malignant lesions, a sarcoma was found in 35 patients. The present study is focused on the long-term prognosis of those 21 patients with a primary resected retroperitoneal sarcoma, recurrent sarcomas and exploratory laparotomies excluded.
The median patient age at the time of surgery was 61 (25-86) years, 57.1 % were males. The duration of symptoms was 3 (1-36) months. A pR0-resection was achieved in 20/21 patients. Among the histopathological tumor types, liposarcomas (n = 10) and leiomyosarcomas (n = 6) were found most frequently. Local recurrence developed in 12 out of 21 patients at 13.5 (5-42) months after the first operation, and in 4 patients distant metastases were observed. The long-term survival of all 21 patients with primary resected retroperitoneal sarcoma was 24 (1-101) months. A more favourable prognosis was seen in patients with leiomyosarcoma as compared with liposarcoma.
Retroperitoneal sarcomas are a heterogeneous entity, and they were found among our own patients in 6.1 % of all primary operatively treated retroperitoneal tumors. The strategy of treatment is complex and dependent on the stage, localization and histopathological characteristics. Long-term survival is limited as a result of the high rate of local recurrence.
由于没有明显的解剖学分区，腹膜后肉瘤更多是在发现大肿瘤及相邻器官受侵时才得以诊断。尽管诊断设备和手术技术有所改进，但即便肿瘤被完整切除，仍经常出现局部复发且预后不良。本研究旨在分析10年间腹膜后肉瘤患者的诊断、治疗及长期预后情况。
1995年1月至2005年1月期间，379例患者在我院接受了原发性腹膜后肿瘤手术。在67例（17.1%）恶性病变中，35例患者被诊断为肉瘤。本研究聚焦于21例原发性腹膜后肉瘤经手术切除患者的长期预后，排除复发性肉瘤和剖腹探查术患者。
手术时患者的中位年龄为61（25 - 86）岁，57.1%为男性。症状持续时间为3（1 - 36）个月。21例患者中有20例实现了pR0切除。在组织病理学肿瘤类型中，脂肪肉瘤（n = 10）和平滑肌肉瘤（n = 6）最为常见。21例患者中有12例在首次手术后13.5（5 - 42）个月出现局部复发，4例患者出现远处转移。21例原发性腹膜后肉瘤经手术切除患者的长期生存时间为24（1 - 101）个月。与脂肪肉瘤患者相比，平滑肌肉瘤患者的预后更佳。
腹膜后肉瘤是一种异质性疾病，在我们自己的患者中，其占所有接受手术治疗的原发性腹膜后肿瘤的6.1%。治疗策略复杂，取决于分期、位置和组织病理学特征。由于局部复发率高，长期生存率有限。
