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腹膜后脂肪肉瘤的外科治疗

Surgical treatment of retroperitoneal liposarcoma.

作者信息

Ikeguchi Masahide, Urushibara Shoichi, Shimoda Ryugo, Saito Hiroaki, Wakatsuki Toshiro

机构信息

Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8504, Japan.

出版信息

Yonago Acta Med. 2014 Dec;57(4):129-32. Epub 2014 Dec 26.

Abstract

BACKGROUND

Retroperitoneal liposarcoma (RL) is a relatively rare tumor and is usually found at the advanced stage. Chemotherapy or radiotherapy for this tumor is not yet defined, and if operable, surgery is the treatment of choice. Complete resection of tumor with wide margins including excision of other organs has been recommended. However, many patients suffer from deterioration of the quality of a postoperative life. In the present study, we retrospectively analyzed the ideal surgical procedures for treating RL.

METHODS

RL patients treated at our institute between 2003 and 2013 amounted to 10. RL was primary in 5 patients and recurrent in the rest 5. We analyzed cases of the 10 patients retrospectively.

RESULTS

Tumor resection was performed for 9 patients, 7 of whom underwent complete tumor resection. RL was well-differentiated in 6 patients and dedifferentiated in 4. We analyzed the overall survival of 10 patients, and the relapse free survival of the operated 9 patients. Patients with well-differentiated RL showed better survival than those with dedifferentiated RL. Even the recurrent RL was huge, complete tumor resection could be performed in the well-differentiated type, but it was difficult in the dedifferentiated type.

CONCLUSION

In the recurrent huge RL, the chance of a margin-negative resection remains low, but surgery remains the treatment of choice. Tumor resection with preserving important organs may improve patients' quality of postoperative life and survival.

摘要

背景

腹膜后脂肪肉瘤(RL)是一种相对罕见的肿瘤,通常在晚期被发现。针对该肿瘤的化疗或放疗尚未明确,如果可手术,手术是首选治疗方法。建议完整切除肿瘤并保证切缘阴性,包括切除其他器官。然而,许多患者术后生活质量下降。在本研究中,我们回顾性分析了治疗RL的理想手术方法。

方法

2003年至2013年在我院接受治疗的RL患者共10例。其中5例为原发性RL,其余5例为复发性RL。我们对这10例患者的病例进行了回顾性分析。

结果

9例患者接受了肿瘤切除术,其中7例实现了肿瘤完整切除。6例患者的RL为高分化型,4例为去分化型。我们分析了10例患者的总生存期以及9例接受手术患者的无复发生存期。高分化型RL患者的生存期优于去分化型患者。即使是复发性巨大RL,高分化型也可实现肿瘤完整切除,但去分化型则很难做到。

结论

在复发性巨大RL中,切缘阴性切除的机会仍然很低,但手术仍是首选治疗方法。保留重要器官的肿瘤切除术可能会改善患者的术后生活质量和生存期。

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本文引用的文献

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Retroperitoneal sarcomas- a challenging problem.腹膜后肉瘤——一个具有挑战性的问题。
Indian J Surg Oncol. 2012 Sep;3(3):215-21. doi: 10.1007/s13193-012-0152-4. Epub 2012 May 30.
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Retroperitoneal giant liposarcoma.腹膜后巨大脂肪肉瘤
Korean J Urol. 2010 Aug;51(8):579-82. doi: 10.4111/kju.2010.51.8.579. Epub 2010 Aug 18.
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The value of surgery for retroperitoneal sarcoma.腹膜后肉瘤手术的价值。
Sarcoma. 2009;2009:605840. doi: 10.1155/2009/605840. Epub 2009 Oct 8.
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Retroperitoneal soft tissue sarcoma: an analysis of radiation and surgical treatment.腹膜后软组织肉瘤:放疗与手术治疗分析
Int J Radiat Oncol Biol Phys. 2007 Jan 1;67(1):158-63. doi: 10.1016/j.ijrobp.2006.08.025. Epub 2006 Nov 2.

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