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腹膜后肉瘤行胰腺切除术的短期和长期手术结果:90 例单中心长期经验。

Short- and long-term surgical outcomes of pancreatic resection for retroperitoneal sarcoma: A long-term single-center experience of 90 cases.

机构信息

Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Sarcoma Center, Peking University Cancer Hospital & Institute, Beijing, China.

出版信息

J Surg Oncol. 2023 Mar;127(4):633-644. doi: 10.1002/jso.27160. Epub 2022 Nov 28.

Abstract

BACKGROUND AND OBJECTIVES

Resection of retroperitoneal sarcoma (RPS) en bloc with pancreas is challenging and controversial. This single-center retrospective study aimed to analyze the impact of pancreatic resection (PR) and its different types on short- and long-term outcomes in patients with RPS.

METHODS

Data from 242 consecutive patients with RPS who underwent surgical treatment at the Peking University Cancer Hospital Sarcoma Center between January 2010 and February 2021 were analyzed. Out of these, 90 patients underwent PR, including pancreaticoduodenectomy (PD) in 31 and distal pancreatectomy (DP) in 59.

RESULTS

Patients in the PR group had a higher major morbidity (37.8% vs. 14.5%) and mortality (8.9% vs. 1.3%) than those in the non-PR group, with a similar 5-year overall survival (OS) rate (46.9% vs. 53.6%). Patients in the PD and DP groups had a slight difference in major morbidity (48.4% vs. 32.2%), mortality (6.4% vs. 10.2%), and 5-year OS rates (43.3% vs. 49.3%). The PR type was not an independent risk factor for major morbidity or OS.

CONCLUSIONS

PR in RPS resection was associated with increased morbidity and mortality with minimal influence on survival. Patients with RPS undergoing PD and DP showed slight differences in terms of safety and OS.

摘要

背景与目的

整块切除腹膜后肉瘤(RPS)并联合胰腺切除极具挑战性且颇具争议。本单中心回顾性研究旨在分析胰腺切除术(PR)及其不同类型对 RPS 患者短期和长期结局的影响。

方法

分析了 2010 年 1 月至 2021 年 2 月期间在北京大学肿瘤医院肉瘤中心接受手术治疗的 242 例连续 RPS 患者的数据。其中 90 例行 PR,包括 31 例行胰十二指肠切除术(PD)和 59 例行胰体尾切除术(DP)。

结果

PR 组患者的主要并发症发生率(37.8%比 14.5%)和死亡率(8.9%比 1.3%)均高于非 PR 组,5 年总生存率(OS)率相似(46.9%比 53.6%)。PD 组和 DP 组患者的主要并发症发生率(48.4%比 32.2%)、死亡率(6.4%比 10.2%)和 5 年 OS 率(43.3%比 49.3%)略有差异。PR 类型不是主要并发症发生率或 OS 的独立危险因素。

结论

RPS 切除术中的 PR 会增加发病率和死亡率,但对生存的影响最小。行 PD 和 DP 的 RPS 患者在安全性和 OS 方面略有差异。

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