Rhu Jinsoo, Cho Chan Woo, Lee Kyo Won, Park Hyojun, Park Jae Berm, Choi Yoon-La, Kim Sung Joo
Department of Surgery Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Medicine (Baltimore). 2017 Aug;96(33):e7537. doi: 10.1097/MD.0000000000007537.
This study sought to identify factors related to the prognosis of intra-abdominal liposarcoma and to determine the optimal minimum duration for remnant tumor screening. Intra-abdominal liposarcoma is associated with high rates of incomplete resection and recurrence requiring a sophisticated follow-up strategy.Patients who underwent surgery for intra-abdominal liposarcoma were included. Cox analyses were used to analyze factors related to recurrence and survival. To determine the optimal minimum duration for remnant tumor screening, patients with recurrence after surgery despite gross complete resection were grouped by a postoperative detection time of 1, 3, or 6 months. Their survivals were compared to the gross incomplete resection group.A total of 168 patients were included. Kaplan-Meier 5-year disease-free survival was 35.9% and overall survival was 66.5%. Multiplicity (HR=2.528, CI=1.585-4.033, P < .001), organ invasion (HR = 1.628, CI = 1.020-2.598, P = .041), and FNCLCC grades (G2,HR = 1.730, CI = 1.000-2.994; G3, HR = 3.812, CI = 2.112-6.880, P < .001) were related to recurrence. Multiplicity (HR = 2.131, CI = 1.050-4.329, P = .036), organ resection ≥3 (HR = 2.857, CI = 1.322-6.174, P = .008), gross incomplete resection (HR = 4.368, CI = 1.890-10.097, P = .001), positive margin (HR = 2.766, CI = 1.367-5.600, P = .005), FNCLCC grade (G2,HR = 2.044, CI = 0.937-4.459; G3,HR = 4.470, CI = 1.893-10.557; P = .003), and RT (HR = 0.322, CI = 0.160-0.648, P = .001) were related to overall survival. Dividing patients into 1 month (P = .097) and 3 months (P = 0.063) did not yield significant differences in univariate analyses, whereas 6 months showed significant difference (P = .015) compared to the gross incomplete resection group. Patients with tumors detected within 6 months showed similar survival to the gross incomplete resection group (HR = 0.552, CI = 0.241-1.260, P = .158), whereas patients with tumor detection after 6 months showed better survival (HR = 0.325, CI = 0.149-0.708, P = .005).In conclusion, minimum duration of 6 months for remnant tumor screening using CT seems optimal.
本研究旨在确定与腹内脂肪肉瘤预后相关的因素，并确定残余肿瘤筛查的最佳最短持续时间。腹内脂肪肉瘤与不完全切除率和复发率高相关，需要复杂的随访策略。纳入接受腹内脂肪肉瘤手术的患者。采用Cox分析来分析与复发和生存相关的因素。为了确定残余肿瘤筛查的最佳最短持续时间，尽管手术肉眼完全切除但术后复发的患者按术后1、3或6个月的检测时间分组。将他们的生存率与肉眼不完全切除组进行比较。共纳入168例患者。Kaplan-Meier法计算的5年无病生存率为35.9%，总生存率为66.5%。肿瘤多灶性（HR=2.528，CI=1.585-4.033，P<0.001）、器官侵犯（HR=1.628，CI=1.020-2.598，P=0.041）和法国国立癌症中心联合会（FNCLCC）分级（G2级，HR=1.730，CI=1.000-2.994；G3级，HR=3.812，CI=2.112-6.880，P<0.001）与复发相关。肿瘤多灶性（HR=2.131，CI=1.050-4.329，P=0.036）、切除器官≥3个（HR=2.857，CI=1.322-6.174，P=0.008）、肉眼不完全切除（HR=4.368，CI=1.890-10.097，P=0.001）、切缘阳性（HR=2.766，CI=1.367-5.600，P=0.005）、FNCLCC分级（G2级，HR=2.044，CI=0.937-4.459；G3级，HR=4.470，CI=1.893-10.557；P=0.003）和放疗（HR=0.322，CI=0.160-0.648，P=0.001）与总生存相关。单因素分析中，将患者分为1个月组（P=0.097）和3个月组（P=0.063）未显示出显著差异，而6个月组与肉眼不完全切除组相比显示出显著差异（P=0.015）。6个月内检测到肿瘤的患者生存率与肉眼不完全切除组相似（HR=0.552，CI=0.241-1.260，P=0.158），而6个月后检测到肿瘤的患者生存率更好（HR=0.325，CI=0.149-0.708，P=0.005）。总之，使用CT进行残余肿瘤筛查的最佳最短持续时间似乎为6个月。
