Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul, 135-710, Korea.
Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
World J Surg. 2018 Jan;42(1):254-262. doi: 10.1007/s00268-017-4157-6.
The purpose of this study is to analyze the clinical impact of radical nephrectomy on retroperitoneal liposarcoma near the kidney.
Data of patients who underwent surgery for unilateral primary retroperitoneal liposarcoma near the kidney were retrospectively collected. Patients were divided into four groups according to whether they underwent nephrectomy and combined resection of other organs. Kaplan-Meier survival analysis was used to estimate disease-free survival and overall survival. Multivariable Cox analysis was used to analyze factors related to disease-free survival and overall survival.
Nephrectomy (HR = 0.260, CI = 0.078-0.873, p = 0.029) had a beneficial effect on disease-free survival, while interaction model of nephrectomy*other organ resection (HR = 4.655, CI = 1.767-12.263, p = 0.002) showed poor disease-free survival. Other organ resection was not related to disease-free survival (HR = 1.543, CI = 0.146-16.251, p = 0.718). Operation method (p = 0.007) and FNCLCC grade (p < 0.001; G2, HR = 1.833, CI = 0.684-4.915, p = 0.228; G3, HR = 9.190, CI = 3.351-25.199, p < 0.001) were significant factors for disease-free survival. While combined organ resection without nephrectomy group (HR = 1.604, CI = 0.167-15.370, p = 0.682) and radical nephrectomy with combined organ resection group (HR = 1.309, CI = 0.448-3.825, p = 0.622) did not show significant difference in disease-free survival from the mass excision only group, radical nephrectomy without combined organ resection group (HR = 0.279, CI = 0.078-0.991, p = 0.048) showed superior disease-free survival.
Radical nephrectomy of unilateral primary retroperitoneal liposarcoma near the kidney has a beneficial effect on disease-free survival.
本研究旨在分析肾周邻近部位脂肪肉瘤根治性肾切除术的临床影响。
回顾性收集单侧原发性肾周邻近部位脂肪肉瘤患者的手术资料。根据是否行肾切除术及合并其他器官切除将患者分为四组。采用 Kaplan-Meier 生存分析估计无病生存率和总生存率。采用多变量 Cox 分析分析无病生存率和总生存率的相关因素。
肾切除术（HR=0.260，CI=0.078-0.873，p=0.029）对无病生存率有益，而肾切除术*其他器官切除术的交互模型（HR=4.655，CI=1.767-12.263，p=0.002）显示无病生存率较差。其他器官切除术与无病生存率无关（HR=1.543，CI=0.146-16.251，p=0.718）。手术方式（p=0.007）和 FNCLCC 分级（p<0.001；G2，HR=1.833，CI=0.684-4.915，p=0.228；G3，HR=9.190，CI=3.351-25.199，p<0.001）是无病生存率的显著因素。而无肾切除术联合器官切除组（HR=1.604，CI=0.167-15.370，p=0.682）和根治性肾切除术联合器官切除组（HR=1.309，CI=0.448-3.825，p=0.622）与单纯肿块切除术组无病生存率无显著差异，根治性肾切除术无联合器官切除组（HR=0.279，CI=0.078-0.991，p=0.048）无病生存率较高。
单侧原发性肾周邻近部位脂肪肉瘤根治性肾切除术对无病生存率有益。
