腹腔内和腹膜后软组织肉瘤——手术治疗和结果。

Intraabdominal and retroperitoneal soft-tissue sarcomas - Surgical treatment and outcomes.

机构信息

Department of Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark.

出版信息

Surg Oncol. 2022 Jun;42:101781. doi: 10.1016/j.suronc.2022.101781. Epub 2022 May 14.

DOI:10.1016/j.suronc.2022.101781

PMID:35643015

Abstract

BACKGROUND

Intraabdominal and retroperitoneal sarcomas (IaRS) are malignant connective tissue tumors. Surgical resection is often the only curative treatment. The primary objective was to report the mid-term outcomes following contemporary treatment protocols and identify prognostic factors.

METHODS

A retrospective review of consecutive patients (n = 107) with IaRS treated at single center from 2013 until 2018 was conducted. Histological diagnosis, tumor grade, perioperative complications, mortality, and long-time survival were registered and retrieved from patient records. Primary and recurrent tumors were analyzed separately.

RESULTS

A total of 107 patients were identified. Median follow-up time was 3.5 years. Thirty-day mortality was 3.4% and 90-day mortality was 5.6% for all tumors. The major complication rate was 18%. The 5-year estimated survival for primary and recurrent tumors was 55.4% and 48.4%, respectively. Multifocal disease was evident in 32% of the patient cohort, and 58% of patients in the recurrent group. Multivariate analysis for survival revealed a hazard ratio (HR) of 3.1 (95% CI 1.68-8.41) for multifocality, HR 2.9 (95% CI 1.28-6.98) for Clavien-Dindo grade, HR 2.3 (95% CI 1.21-4.31) for tumor grades 2 or 3, and HR 1.002 (95% CI 1.001-1.004) for surgical margins.

CONCLUSIONS

Our study found overall acceptable morbidity and mortality, and identified prognostic markers for overall survival. Recurrent tumors were not associated with worse survival. Multifocality is associated with a worse overall survival. The prognostic factors identified were; tumor grade, multifocality, intralesional margins and postoperative complications.

摘要

背景

腹腔内和腹膜后肉瘤（IaRS）是恶性结缔组织肿瘤。手术切除通常是唯一的治愈性治疗方法。主要目的是报告采用当代治疗方案的中期结果，并确定预后因素。

方法

对 2013 年至 2018 年在单中心治疗的连续患者（n=107）进行回顾性分析。从患者记录中登记和检索组织学诊断、肿瘤分级、围手术期并发症、死亡率和长期生存情况。分别分析原发性和复发性肿瘤。

结果

共确定 107 例患者。中位随访时间为 3.5 年。所有肿瘤的 30 天死亡率为 3.4%，90 天死亡率为 5.6%。主要并发症发生率为 18%。原发性和复发性肿瘤的 5 年估计生存率分别为 55.4%和 48.4%。在患者队列中，32%存在多发病灶，复发性肿瘤组中 58%存在多发病灶。生存的多变量分析显示，多发病灶的危险比（HR）为 3.1（95%CI 1.68-8.41），Clavien-Dindo 分级的 HR 为 2.9（95%CI 1.28-6.98），肿瘤分级为 2 或 3 的 HR 为 2.3（95%CI 1.21-4.31），手术切缘的 HR 为 1.002（95%CI 1.001-1.004）。