Zhang Q, Li J M, Liu J L, Wei Y Z
Department of Orthopedics, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
Department of General Surgery, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
Zhonghua Zhong Liu Za Zhi. 2019 Dec 23;41(12):943-948. doi: 10.3760/cma.j.issn.0253-3766.2019.12.011.
To investigate the relevant prognostic factors of liposarcoma (LPS). The data of 78 patients with LPS treated in our hospital from July 2009 to March 2017 were reviewed. The 78 patients included 41 males and 37 females, and the average age was (60.5 ±13.4) years (ranged from 18 to 85 years). Among the 78 LPS patients, 27 were well-differentiated LPS, 13 were myxoid LPS, 35 were dedifferentiated LPS and 3 were pleomorphic LPS.The distribution of lesion location included 40 cases of extremities and 38 cases of retroperitoneal. 21 cases were treated with radical excision, 57 cases were treated with marginal resection. 7 patients were treated with postoperative radiotherapy and 9 patients with postoperative chemotherapy. Progression free survival (PFS) and overall survival (OS) of LPS patients were analyzed as clinical outcomes. Prognostic factors were analyzed by univariate and multivariate analyses. 43 patients had local recurrence (9 of extremities/ 34 of retroperitoneal), 18 patients with metastasis (4 of extremities/ 14 of retroperitoneal). The 5-year PFS rate was 31.4% and 5-year OS rate was 44.3%. Univariate analysis showed that the histological subtype and the tumor location were related with PFS (<0.05), while the histological subtype, the tumor location, the tumor size, the recurrence and metastasis were related with OS (<0.05). Multivariate cox regression analysis showed that the tumor location was the independent prognostic factor of PFS (<0.05), while the histological subtype and metastasis were the independent prognostic factors of OS (<0.05). The median PFS of patients with myxoid LPS treated with radiotherapy was 34.6 months, which was significantly longer than 28.3 months of myxoid LPS patients without radiotherapy (<0.05). The tumor location is an independent prognostic factor of PFS in LPS patients.Retroperitoneal LPS is more prone to relapse and metastasize. OS is affected by pathological subtype and metastasis. Radiotherapy can improve the PFS of patients with myxoid LPS.
探讨脂肪肉瘤（LPS）的相关预后因素。回顾了2009年7月至2017年3月在我院接受治疗的78例LPS患者的数据。78例患者中，男性41例，女性37例，平均年龄为（60.5±13.4）岁（年龄范围18至85岁）。78例LPS患者中，高分化LPS 27例，黏液样LPS 13例，去分化LPS 35例，多形性LPS 3例。病变部位分布包括四肢40例，腹膜后38例。21例行根治性切除，57例行边缘性切除。7例患者接受术后放疗，9例患者接受术后化疗。分析LPS患者的无进展生存期（PFS）和总生存期（OS）作为临床结局。通过单因素和多因素分析来分析预后因素。43例患者出现局部复发（四肢9例/腹膜后34例），18例患者发生转移（四肢4例/腹膜后14例）。5年PFS率为31.4%，5年OS率为44.3%。单因素分析显示，组织学亚型和肿瘤部位与PFS相关（<0.05），而组织学亚型、肿瘤部位、肿瘤大小、复发和转移与OS相关（<0.05）。多因素Cox回归分析显示，肿瘤部位是PFS的独立预后因素（<0.05），而组织学亚型和转移是OS的独立预后因素（<0.05）。接受放疗的黏液样LPS患者的中位PFS为34.6个月，明显长于未接受放疗的黏液样LPS患者的28.3个月（<0.05）。肿瘤部位是LPS患者PFS的独立预后因素。腹膜后LPS更容易复发和转移。OS受病理亚型和转移的影响。放疗可改善黏液样LPS患者的PFS。
