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原发性腹膜后肉瘤手术后的生存和预后因素:单中心经验。

Survival and prognostic factors of primary retroperitoneal sarcomas after surgery: a single-center experience.

机构信息

Clinical Teaching Hospital of Medical School, Northern Jiangsu People's Hospital, Nanjing University, Yangzhou, China.

Department of General Surgery, Taizhou Fourth People's Hospital, Taizhou, China.

出版信息

Langenbecks Arch Surg. 2024 Jul 15;409(1):216. doi: 10.1007/s00423-024-03405-w.

Abstract

PURPOSE

The percentage of retroperitoneal sarcomas (RPS) among all soft tissue sarcomas ranges from 10 to 15%. Surgery remains the gold standard for RPS. In this study, we analyzed the impact of surgical treatment for primary RPS on recurrence and overall mortality at a Chinese institution and identified and evaluated prognostic variables.

METHODS

Data from patients with RPS who underwent surgical treatment were retrospectively analyzed. The patients were treated at a single center from January 2000 to June 2018. Retrospectively collected demographic, clinicopathological, and surgical factors were examined. Overall survival (OS) and disease-free survival (DSF) were used as the primary endpoints. Predicted 5-year survival rates, encompassing both DFS and OS, were derived from the Sarculator prognostic nomogram.

RESULTS

A total of 110 patients met the inclusion criteria. The median follow-up time after surgery for patients with primary RPS was 5.3 years. During this period, 59 patients died. The 5-year OS and DFS estimates were 63.5% and 35.3%, respectively. In a multivariate analysis, poor OS following surgical treatment of primary RPS was independently correlated with FNCLCC grade (p < 0.001) and surgical margin status (p = 0.016). FNCLCC grade (p = 0.001) and surgical margin status (p = 0.002) were also independently associated with poor DFS. The C-indices for 5-year OS and DFS survival utilizing the Sarculator prognostic nomogram were 0.71 and 0.73 respectively.

CONCLUSION

The overall mortality rate of patients with RPS was considered acceptable. OS and DFS prognostic markers were established for primary RPS. Tumor grade and intraregional margins are other factors that affect survival and recurrence.

摘要

目的

腹膜后肉瘤(RPS)占所有软组织肉瘤的 10%至 15%。手术仍然是 RPS 的金标准。本研究分析了中国某机构对原发性 RPS 进行手术治疗对复发和总死亡率的影响,并确定和评估了预后变量。

方法

回顾性分析了接受手术治疗的 RPS 患者的数据。患者于 2000 年 1 月至 2018 年 6 月在一家单中心接受治疗。回顾性收集了人口统计学、临床病理和手术因素。总生存(OS)和无病生存(DFS)是主要终点。预测的 5 年生存率,包括 DFS 和 OS,是从 Sarculator 预后列线图得出的。

结果

共 110 例患者符合纳入标准。原发性 RPS 患者手术后的中位随访时间为 5.3 年。在此期间,59 例患者死亡。5 年 OS 和 DFS 估计值分别为 63.5%和 35.3%。多变量分析显示,原发性 RPS 手术后 OS 不良与 FNCLCC 分级(p<0.001)和手术切缘状态(p=0.016)独立相关。FNCLCC 分级(p=0.001)和手术切缘状态(p=0.002)也与不良 DFS 独立相关。利用 Sarculator 预后列线图预测的 5 年 OS 和 DFS 生存的 C 指数分别为 0.71 和 0.73。

结论

RPS 患者的总体死亡率被认为是可以接受的。为原发性 RPS 建立了 OS 和 DFS 预后标志物。肿瘤分级和区域内切缘是影响生存和复发的其他因素。

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