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巨大腹膜后去分化脂肪肉瘤的围手术期策略与结局——一项回顾性队列研究的结果

Perioperative strategy and outcome in giant retroperitoneal dedifferentiated liposarcoma-results of a retrospective cohort study.

作者信息

Bachmann Robert, Eckert Franziska, Gelfert Daniel, Strohäker Jens, Beltzer Christian, Ladurner Ruth

机构信息

Department of General, Visceral and Transplantation Surgery, University of Tübingen, Hoppe-Seyler Str. 3, 72076, Tübingen, Germany.

Department of Radiation Oncology, University of Tübingen, Hoppe-Seyler Str. 3, 72076, Tübingen, Germany.

出版信息

World J Surg Oncol. 2020 Nov 12;18(1):296. doi: 10.1186/s12957-020-02069-2.

Abstract

BACKGROUND AND OBJECTIVES

Retroperitoneal liposarcoma (RPLS) are common soft tissue sarcomas of adulthood. The aim of this study is to show resectability of even giant liposarcomas and to identify factors associated with recurrence and survival in primary retroperitoneal liposarcomas.

METHODS

We retrospectively reviewed the records of patients with retroperitoneal liposarcoma. Seventy-seven patients met inclusion criteria. Out of these 10 patients with primary giant, dedifferentiated retroperitoneal liposarcomas were operated with en bloc compartment resection with intention of radical resection. Treatment consisted of neoadjuvant radiochemotherapy and surgical resection or surgical resection.

RESULTS

In 6 patients, neoadjuvant radiochemotherapy was performed; 3 patients were treated with surgical resection alone and 1 patient received adjuvant chemotherapy. The median diameter of tumor size was 360 mm (300 to 440 mm). Operative outcome showed complete resection in all 10 patients. Local tumor free survival was in median 19 month. Tumor recurrence was seen in 3 of 4 patients (75%) without neoadjuvant radiochemotherapy, and in 2 of 6 patients (33%) after neoadjuvant radiochemotherapy in 2 years follow-up.

CONCLUSION

Even in case of giant retroperitoneal liposarcoma, complete resection is possible and remains the principal treatment. The rate of recurrence was improved in patients with neoadjuvant radiochemotherapy.

摘要

背景与目的

腹膜后脂肪肉瘤(RPLS)是成人常见的软组织肉瘤。本研究的目的是展示即使是巨大脂肪肉瘤的可切除性,并确定原发性腹膜后脂肪肉瘤复发和生存的相关因素。

方法

我们回顾性分析了腹膜后脂肪肉瘤患者的病历。77例患者符合纳入标准。其中10例原发性巨大、去分化腹膜后脂肪肉瘤患者接受了整块间室切除术,旨在进行根治性切除。治疗包括新辅助放化疗和手术切除或单纯手术切除。

结果

6例患者接受了新辅助放化疗;3例患者仅接受手术切除,1例患者接受辅助化疗。肿瘤大小的中位直径为360毫米(300至440毫米)。手术结果显示所有10例患者均实现了完全切除。局部无瘤生存期的中位数为19个月。在2年的随访中,4例未接受新辅助放化疗的患者中有3例(75%)出现肿瘤复发,6例接受新辅助放化疗的患者中有2例(33%)出现复发。

结论

即使是巨大的腹膜后脂肪肉瘤,也有可能实现完全切除,且仍然是主要的治疗方法。新辅助放化疗患者的复发率有所改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3187/7664077/98904636c720/12957_2020_2069_Fig1_HTML.jpg

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