Zhang G, Chen K K, Manivel C, Fraley E E
Department of Urologic Surgery, University of Minnesota Hospital and Clinic, Minneapolis.
J Urol. 1989 May;141(5):1107-10. doi: 10.1016/s0022-5347(17)41184-0.
A total of 62 patients with retroperitoneal or genitourinary sarcoma was treated at our institutions during the last 46 years. Of the patients 51 were followed for at least 5 years or until they died (median followup 11 years); 5 patients were lost to followup. The most common site was the retroperitoneum. Liposarcoma, leiomyosarcoma and malignant fibrous histiocytoma were the most common tumors (74 per cent). Tumors were completely resected in 42 patients (68 per cent) and incompletely resected in 11, while a biopsy only was performed in 9. Some patients also received adjuvant radiation therapy and/or chemotherapy. There were no long-term survivors among patients with unresectable tumors. Over-all 3 and 5-year survival rates were 68 and 39 per cent, respectively. The histological type of the tumor appeared to have prognostic significance. The highest 5-year survivals were for liposarcoma (70 per cent), malignant fibrous histiocytoma (33 per cent) and leiomyosarcoma (13 per cent). The mean survival for patients after adjuvant radiation therapy or chemotherapy was similar to that after a radical operation alone. The primary cause of treatment failure was local recurrence (45 per cent of the patients), which was detected within 3 years of complete resection in most cases (82 per cent). Complete extirpation that provided adequate margins free of tumor was the most effective initial treatment and provided the best chance for cure.
在过去46年中，我们机构共治疗了62例腹膜后或泌尿生殖系统肉瘤患者。其中51例患者接受了至少5年的随访或直至死亡（中位随访时间为11年）；5例患者失访。最常见的部位是腹膜后。脂肪肉瘤、平滑肌肉瘤和恶性纤维组织细胞瘤是最常见的肿瘤（74%）。42例患者（68%）的肿瘤得到了完整切除，11例为不完全切除，9例仅进行了活检。部分患者还接受了辅助放疗和/或化疗。无法切除的肿瘤患者中无长期存活者。总体3年和5年生存率分别为68%和39%。肿瘤的组织学类型似乎具有预后意义。5年生存率最高的是脂肪肉瘤（70%）、恶性纤维组织细胞瘤（33%）和平滑肌肉瘤（13%）。辅助放疗或化疗后患者的平均生存期与单纯根治性手术后相似。治疗失败的主要原因是局部复发（45%的患者），大多数情况下（82%）在完整切除后3年内被发现。能够提供足够切缘且无肿瘤残留的完整切除是最有效的初始治疗方法，也是治愈的最佳机会。
