Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania.
Department of Surgery, Temple University Hospital, Philadelphia, Pennsylvania.
J Surg Res. 2019 Dec;244:34-41. doi: 10.1016/j.jss.2019.05.016. Epub 2019 Jul 3.
Sarcomas are malignant tumors of connective tissue that can vary widely in etiology. Parameters such as grade, extent of resection, and tumor integrity have been shown to affect prognosis. Our principal aim was to examine associations between the laterality of retroperitoneal sarcomas and tumor characteristics, treatment, and patient outcomes.
We performed a retrospective study of patients treated at our tertiary referral center with a diagnosis of primary retroperitoneal sarcoma who underwent tumor resection. Categorical variables were compared using the chi-square test, whereas continuous variables were compared using one-way analysis of variance. Cox regression was used to estimate the risk of death.
Data from 106 patients were analyzed. A greater proportion of bilateral or midline tumors were leiomyosarcomas (P = 0.02), whereas right-sided tumors were more likely to be liposarcoma (P = 0.02). There was no significant relationship between laterality and tumor grade or stage. Two-thirds of patients had at least one contiguous organ resected (n = 68, 65.4%). Patients with nephrectomy during sarcoma resection were more likely to have right-sided disease (P = 0.02). Splenectomy and pancreatectomy were associated with left-sided disease (P < 0.01; P < 0.01), and pancreaticoduodenectomies with bilateral or midline disease (P < 0.001). Adjusting for age, sex, race, grade, stage, histology, and treatment, there was no increased risk of death or recurrence based on laterality.
Although laterality did not seem to have a measurable relationship with patient outcomes or survival, there was a significant association between laterality, tumor histology, and resection of contiguous organs. These preliminary findings warrant further investigation.
肉瘤是一种起源于结缔组织的恶性肿瘤，其病因差异较大。分级、切除范围和肿瘤完整性等参数已被证明与预后相关。我们的主要目的是研究腹膜后肉瘤的侧别与肿瘤特征、治疗和患者结局之间的关系。
我们对在我们的三级转诊中心接受治疗的原发性腹膜后肉瘤患者进行了回顾性研究，这些患者接受了肿瘤切除术。使用卡方检验比较分类变量，使用单因素方差分析比较连续变量。使用 Cox 回归估计死亡风险。
分析了 106 例患者的数据。双侧或中线肿瘤中平滑肌肉瘤的比例较高（P=0.02），而右侧肿瘤更可能是脂肪肉瘤（P=0.02）。肿瘤侧别与肿瘤分级或分期之间无显著关系。三分之二的患者至少切除了一个相邻器官（n=68，65.4%）。肉瘤切除术中行肾切除术的患者右侧疾病的可能性更高（P=0.02）。脾切除术和胰切除术与左侧疾病相关（P<0.01；P<0.01），而胰十二指肠切除术与双侧或中线疾病相关（P<0.001）。在校正年龄、性别、种族、分级、分期、组织学和治疗后，侧别与死亡或复发风险无关。
尽管侧别似乎与患者结局或生存率没有明显关系，但侧别与肿瘤组织学和相邻器官切除之间存在显著关联。这些初步发现值得进一步研究。
