Sriussadaporn Suvit, Sriussadaporn Sukanya, Pak-Art Rattaplee, Kritayakirana Kritaya, Prichayudh Supparerk, Samorn Pasurachate, Narueponjirakul Natawat, Aimsupanimitr Punthita, Uthaipaisanwong Apinan
Department of Surgery, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand.
Asian Biomed (Res Rev News). 2024 Oct 31;18(5):236-243. doi: 10.2478/abm-2024-0031. eCollection 2024 Oct.
Retroperitoneal sarcoma (RPS) is rare and difficult to treat with a high recurrent rate. Very little data regarding primary RPS exists in Thailand.
To study the outcome of treatment of primary RPS at a tertiary University Hospital in Bangkok, Thailand.
All patients who had RPS undergoing the first surgical resection at King Chulalongkorn Memorial Hospital from June 2003 to December 2019 were retrospectively enrolled in the study. Perioperative management, results of treatment, postoperative complications, and outcome were analyzed.
Thirty-eight patients entered the study. Large abdominal mass was the most common presentation (90%). Liposarcoma was the most common histology (58%). Twenty patients (53%) had preoperative core needle biopsy and 21 (55%) underwent preoperative radiotherapy (RT). The tumor size ranged from 3 cm to 48 cm (median 22 cm). Five patients (13%) had total mass removal only while 33 (87%) had complete gross resection with ≥1 visceral organ resection. Surgical margins classified as R0, R1, and R2 were 61%, 34%, and 5%, respectively. Five patients (16%) had postoperative complications. There was no 30-day postoperative mortality. The local recurrence rate was 34%. Survival analysis revealed a 5-year overall survival rate of 37% and 5-year disease-free survival rate of 29%. The 5-year and 10-year recurrent rates were 71% and 95%, respectively. Multivariate analysis showed that preoperative radiation was the only factor reducing recurrence (19% vs. 53%, OR: 0.21, = 0.011).
The preliminary study of outcome of the treatment of primary RPS at our institution showed a fair prognosis of this rare malignancy despite our aggressive surgical approaches. Preoperative radiation may help reduce recurrence in selected primary RPS patients.
腹膜后肉瘤（RPS）较为罕见，治疗困难，复发率高。泰国关于原发性RPS的数据极少。
研究泰国曼谷一家三级大学医院原发性RPS的治疗结果。
回顾性纳入2003年6月至2019年12月在朱拉隆功国王纪念医院接受首次手术切除的所有RPS患者。分析围手术期管理、治疗结果、术后并发症及预后情况。
38例患者纳入研究。腹部巨大肿块是最常见的表现（90%）。脂肪肉瘤是最常见的组织学类型（58%）。20例患者（53%）术前行粗针穿刺活检，21例（55%）术前行术前放疗（RT）。肿瘤大小3 cm至48 cm（中位值22 cm）。5例患者（13%）仅行肿瘤全切，3例（87%）行≥1个内脏器官切除的根治性切除。手术切缘分类为R0、R1和R2的分别为61%、34%和5%。5例患者（16%）出现术后并发症。术后30天无死亡病例。局部复发率为34%。生存分析显示5年总生存率为37%，5年无病生存率为29%。5年和10年复发率分别为71%和95%。多因素分析显示术前放疗是唯一降低复发的因素（19%对53%，OR：0.21，P = 0.011）。
我们机构对原发性RPS治疗结果的初步研究表明，尽管采取了积极的手术方法，但这种罕见恶性肿瘤的预后尚可。术前放疗可能有助于降低部分原发性RPS患者的复发率。
