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腹膜后肉瘤切除术后的结果。

Outcome following resection of retroperitoneal sarcoma.

机构信息

Sarcoma Unit, Department of Academic Surgery, The Royal Marsden Hospital NHS Foundation Trust, London, UK.

出版信息

Br J Surg. 2015 Dec;102(13):1698-709. doi: 10.1002/bjs.9934. Epub 2015 Sep 23.

Abstract

BACKGROUND

Retroperitoneal sarcoma comprises a range of different histological subtypes with dissimilar behaviour and biology. This study sought to characterize the morbidity and mortality associated with multivisceral resection and oncological outcomes according to subtype.

METHODS

All patients undergoing resection of primary retroperitoneal sarcoma at the Royal Marsden Hospital between January 2005 and December 2014 were identified from a database.

RESULTS

Some 362 patients underwent resection, with 292 requiring multivisceral resection. The 30-day mortality rate was 1·4 per cent (5 patients), the 30-day morbidity rate was 15·7 per cent (57 patients), and 27 patients required a return to theatre. Age over 75 years was predictive of 30-day mortality (hazard ratio 1·37, 95 per cent c.i. 1·13 to 1·65). The overall disease-specific survival rate at 3 years was 81·2 per cent. For well differentiated liposarcoma, dedifferentiated liposarcoma and leiomyosarcoma, 3-year local recurrence-free survival rates were 98 (95 per cent c.i. 83 to 99), 56·7 (45·7 to 66·2) and 80 (67 to 89) per cent respectively. At 3 years the distant metastasis-free survival rate was 100, 85·9 (77·4 to 91·4) and 65 (49 to 77) per cent, and the disease-specific survival rate was 97 (89 to 99), 78·5 (74·6 to 82·4) and 79 (63 to 85) per cent for well differentiated liposarcoma, dedifferentiated liposarcoma and leiomyosarcoma respectively.

CONCLUSION

Resection of retroperitoneal sarcoma was associated with a 30-day mortality rate of less than 2 per cent and a morbidity rate of 15·7 per cent. The overall 3-year disease-specific survival rate was 81·2 per cent.

摘要

背景

腹膜后肉瘤包含一系列具有不同行为和生物学特征的不同组织学亚型。本研究旨在根据亚型描述多脏器切除术相关发病率和死亡率以及肿瘤学结果。

方法

从数据库中确定 2005 年 1 月至 2014 年 12 月在皇家马斯登医院接受原发性腹膜后肉瘤切除术的所有患者。

结果

362 例患者接受了切除术,其中 292 例需要多脏器切除术。30 天死亡率为 1.4%(5 例),30 天发病率为 15.7%(57 例),27 例需要再次手术。年龄超过 75 岁与 30 天死亡率相关(风险比 1.37,95%置信区间 1.13 至 1.65)。3 年疾病特异性生存率为 81.2%。对于高分化脂肪肉瘤、去分化脂肪肉瘤和 leiomyosarcoma,3 年局部无复发生存率分别为 98%(83%至 99%)、56.7%(45.7%至 66.2%)和 80%(67%至 89%)。3 年后,无远处转移生存率为 100%、85.9%(77.4%至 91.4%)和 65%(49%至 77%),疾病特异性生存率为 97%(89%至 99%)、78.5%(74.6%至 82.4%)和 79%(63%至 85%),分别为高分化脂肪肉瘤、去分化脂肪肉瘤和 leiomyosarcoma。

结论

腹膜后肉瘤切除术的 30 天死亡率低于 2%,发病率为 15.7%。3 年总体疾病特异性生存率为 81.2%。

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