Dalton R R, Donohue J H, Mucha P, van Heerden J A, Reiman H M, Chen S P
Department of Surgery, Mayo Clinic Rochester, Minn 55905.
Surgery. 1989 Oct;106(4):725-32; discussion 732-3.
The records of 116 adult patients who underwent operative treatment for retroperitoneal sarcomas at the Mayo Clinic during the years 1963 to 1982 were reviewed. Clinical, pathologic, and treatment variables were analyzed for their influence on recurrence and death from disease. Leiomyosarcomas, liposarcomas, and malignant fibrous histiocytomas represented 93% of the tumors. The primary tumor was completely excised in 54% of patients. Recurrent tumor developed in 68% of patients (median time to recurrence, 1.3 years). Tumor fixation to adjacent structures (T3 tumor) or a high-grade tumor (G2-4) identified patients at increased risk for recurrent disease. Five-year and 10-year survival rates were 40% and 22%, respectively. Survival was significantly better for patients who had (1) complete surgical excision of their tumors, (2) low-grade tumors (G1), (3) tumors not fixed to adjacent retroperitoneal structures (T1 and T2 sarcomas), and (4) tumors without metastases when initially seen. Complete surgical excision offers patients with retroperitoneal sarcomas the best chance for long-term survival, but recurrent disease remains a vexing problem. The therapeutic challenges in the treatment of retroperitoneal sarcomas continue to be the development of therapy that will increase the rate of complete resection, decrease the rate of local recurrence, and enhance patient survival.
回顾了1963年至1982年间在梅奥诊所接受腹膜后肉瘤手术治疗的116例成年患者的记录。分析了临床、病理和治疗变量对疾病复发和死亡的影响。平滑肌肉瘤、脂肪肉瘤和恶性纤维组织细胞瘤占肿瘤的93%。54%的患者原发性肿瘤被完全切除。68%的患者出现复发性肿瘤（复发的中位时间为1.3年）。肿瘤与相邻结构固定（T3肿瘤）或高级别肿瘤（G2-4）表明患者复发疾病的风险增加。5年和10年生存率分别为40%和22%。对于以下患者，生存率明显更高：（1）肿瘤接受了完全手术切除；（2）低级别肿瘤（G1）；（3）肿瘤未与相邻腹膜后结构固定（T1和T2肉瘤）；（4）初诊时无转移的肿瘤。完全手术切除为腹膜后肉瘤患者提供了最佳的长期生存机会，但复发性疾病仍然是一个棘手的问题。腹膜后肉瘤治疗中的挑战仍然是开发能够提高完全切除率、降低局部复发率并提高患者生存率的治疗方法。
