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肝脏切除术治疗软组织肉瘤肝转移:一项全国性研究。

Liver Resection for Hepatic Metastases from Soft Tissue Sarcoma: A Nationwide Study.

机构信息

Department of Surgical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands.

Department of Surgical Oncology, University Medical Centre Utrecht, Cancer Center, Utrecht, The Netherlands.

出版信息

Dig Surg. 2019;36(6):479-486. doi: 10.1159/000493389. Epub 2018 Sep 25.

Abstract

BACKGROUND

This study aims to evaluate the feasibility and safety of resection of sarcoma liver metastases, and to identify possible prognostic factors for long-term survival.

METHODS

All patients who underwent resection of liver metastases of sarcoma in the Netherlands from 1998 to 2014 were included. Study data was retrospectively collected from patient files. Survival rates were calculated using Kaplan-Meier survival analysis.

RESULTS

Some 38 patients treated in 16 hospitals were included (15 male, 23 female). The median age was 57 years (37-80 years). The most common histological subtype was leiomyosarcoma (63%). The predominant site of primary tumour was the abdomen (59%). R0 resection was achieved in 16 patients. Mortality was 3 and 16% of included patients had 1 or more complications. The median follow-up period was 18 months (range 1-161). After liver resection, 1-, 3-, and 5-year survival were 88, 54, and 42% respectively. Median overall survival was 46 months (1-161 months). One- and three-year progression-free survival (PFS) after liver resection were 54 and 19% respectively. Median PFS was 16 months (1-61 months).

CONCLUSIONS

Liver surgery for sarcoma metastases is safe and leads to a relatively good survival. The choice for surgical treatment should always be discussed in a multidisciplinary sarcoma and liver team.

摘要

背景

本研究旨在评估肉瘤肝转移切除术的可行性和安全性,并确定可能影响长期生存的预后因素。

方法

纳入 1998 年至 2014 年期间在荷兰接受肉瘤肝转移切除术的所有患者。从患者病历中回顾性收集研究数据。采用 Kaplan-Meier 生存分析计算生存率。

结果

纳入 16 家医院的 38 例患者(男 15 例,女 23 例)。中位年龄为 57 岁(37-80 岁)。最常见的组织学亚型为平滑肌肉瘤(63%)。原发肿瘤的主要部位是腹部(59%)。16 例患者达到 R0 切除。死亡率为 3%,16%的患者有 1 种或多种并发症。中位随访时间为 18 个月(1-161 个月)。肝切除后 1 年、3 年和 5 年生存率分别为 88%、54%和 42%。中位总生存时间为 46 个月(1-161 个月)。肝切除后 1 年和 3 年无进展生存率(PFS)分别为 54%和 19%。中位 PFS 为 16 个月(1-61 个月)。

结论

肉瘤肝转移的手术治疗是安全的,可获得较好的生存。手术治疗的选择应始终在多学科肉瘤和肝脏团队中进行讨论。

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