van Doorn R C, Gallee M P, Hart A A, Gortzak E, Rutgers E J, van Coevorden F, Keus R B, Zoetmulder F A
Department of Surgical Oncology, The Netherlands Cancer Institute, Amsterdam.
Cancer. 1994 Feb 1;73(3):637-42. doi: 10.1002/1097-0142(19940201)73:3<637::aid-cncr2820730322>3.0.co;2-y.
Soft tissue malignancies of the retroperitoneum are rare. Surgery is commonly considered the first choice of treatment. There is still no consensus concerning the precise value of the extent of surgery and the value of additional treatment modalities.
From 1973 to 1990, 34 patients were initially treated by surgery for retroperitoneal soft tissue sarcomas at the Netherlands Cancer Institute. In a retrospective study, the prognostic effect of extent of primary surgery and postoperative radiation therapy was examined.
Liposarcomas (47%) and leiomyosarcomas (29%) were the histologic types most commonly found. Grade of malignancy was defined as medium to high (II/III) in 44% and as low (I) in 38%. Complete (extended or marginal) resection of the tumor was achieved in 29 patients. After complete resection, the 5-year survival rate and the local recurrence rate were 35% and 63%, respectively. Extended surgery (performed in eight patients) showed a local recurrence rate of 50%. Thirteen patients received high-dose postoperative radiation therapy, which was found to have a significant favorable effect on the recurrence-free interval (P < 0.01).
We conclude that complete (extended) resection followed by high-dose postoperative radiation therapy improves the prognostic outcome of patients with retroperitoneal soft tissue sarcomas.
腹膜后软组织恶性肿瘤较为罕见。手术通常被视为首选治疗方法。关于手术范围的精确价值以及其他治疗方式的价值，目前仍未达成共识。
1973年至1990年期间，荷兰癌症研究所对34例腹膜后软组织肉瘤患者最初采用手术治疗。在一项回顾性研究中，研究了初次手术范围和术后放疗的预后效果。
最常见的组织学类型为脂肪肉瘤（47%）和平滑肌肉瘤（29%）。44%的恶性程度为中至高度（II/III级），38%为低度（I级）。29例患者实现了肿瘤的完整（扩大或边缘性）切除。完整切除后，5年生存率和局部复发率分别为35%和63%。扩大手术（8例患者接受）的局部复发率为50%。13例患者接受了高剂量术后放疗，结果发现其对无复发生存期有显著的有利影响（P < 0.01）。
我们得出结论，完整（扩大）切除后进行高剂量术后放疗可改善腹膜后软组织肉瘤患者的预后结果。
