中国癌症杂志 ›› 2017, Vol. 27 ›› Issue (12): 980-984.doi: 10.19401/j.cnki.1007-3639.2017.12.011

• 论著 • 上一篇    下一篇

复发性腹膜后肉瘤的手术治疗探讨

韩 毓1,柴宇啸1,张 怡1,张洪强1,王 炳1,屈国伦1,曲兴龙1,王春萌2,陈 勇2   

  1. 1. 复旦大学附属肿瘤医院闵行分院肿瘤外科,上海 200240 ;
    2. 复旦大学附属肿瘤医院骨软组织肿瘤外科,复旦大学上海医学院肿瘤学系,上海
    200032
  • 出版日期:2017-12-30 发布日期:2018-01-11
  • 通信作者: 陈 勇 E-mail:505248448@qq.com

Analysis of surgical treatment for recurrent retroperitoneal sarcoma

HAN Yu1, CHAI Yuxiao1, ZHANG Yi1, ZHANG Hongqiang1, WANG Bing1, QU Guolun1, QU Xinglong1, WANG Chunmeng2, CHEN Yong2   

  1. 1. Department of Oncosurgery, Minhang Branch, Shanghai Cancer Hospital, Fudan University, Shanghai 200240, China; 2. Department of Soft Tissue Surgery, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
  • Published:2017-12-30 Online:2018-01-11
  • Contact: CHEN Yong E-mail: 505248448@qq.com

摘要: 背景与目的:腹膜后肉瘤是罕见的恶性肿瘤,彻底手术切除是最有效的治疗方法,但是其术后复发率很高。复发性腹膜后肉瘤通常在复查时被发现,治疗方法仍是手术切除,但由于其解剖层次不清,因此手术难度大,出血多。该研究旨在探讨复发性腹膜后肉瘤的诊断及手术方式。方法:回顾性分析2007年10月—2016年10月收治的25例复发性腹膜后肉瘤,根据手术情况分组后使用log-rank检验对完整切除组与部分切除或活检组两者进行单因素预后分析,并使用Kaplan-Meier法计算生存率。结果:全组25例完整切除16例,占64.0%(16/25),部分切除6例,占24.0%(6/25),未切除活检为3例,占12.0%(3/25)。完整切除中联合脏器切除8例,占完整切除的50.0%(8/16)。24例获随访,完整切除和部分切除两者5年生存率为56.3%(9/16)和20.0%(1/5),差异有统计学意义(P<0.05)。结论:手术切除是治疗复发性腹膜后肉瘤最有效的方法,联合脏器切除能提高肿瘤完整切除率。本病术后复发率高,术后需密切随访。

关键词: 复发性腹膜后肉瘤, 手术切除, 预后

Abstract: Background and purpose: Retroperitoneal sarcoma is a rare kind of malignant neoplasms. Complete resection plays a key role in the treatment of retroperitoneal sarcoma, but the recurrence rate is high. Most of the patients with recurrent retroperitoneal sarcoma were eventually diagnosed by a follow-up examination. Again a hard surgical resection with bleeding profusely was approached because of its unclear anatomical level. In this study, we investigated the clinical features, treatment modalities and prognosis of patients with recurrent retroperitoneal sarcoma. Methods: Twenty-five patients with recurrent retroperitoneal sarcomas admitted from Oct. 2007 to Oct. 2016 for surgical resection in a single institution were divided into the complete resection group and partial excision and biopsy group after the operation. Statistical analysis was done using the univariate logistic regression analysis. The survival rate was calculated using Kaplan-Meier curve. Results: A total of 25 cases were enrolled in this study. Grossly complete resection was performed in 16 cases (complete excision rate was 64.0%). Partial excision and biopsy were performed in 6 (24.0%) and 3 (12.0%) cases respectively. Among 16 patients who underwent complete gross resection, 8 had concomitant resection of adjacent viscera (50%). Twenty-four cases had full followup data. The 5-year survival rates of complete resection and partial resection were 56.3% (9/16) and 20% (1/5). The differences between the two groups were significant (P<0.05). Conclusion: Complete resection plays an important role in the treatment for recurrent retroperitoneal sarcoma. The study demonstrates that concomitant resection of the adjacent viscera can improve the rate of complete gross resection. Because of the high recurrence rate in malignant tumors, long-term follow-up care is needed.

Key words: Retroperitoneal sarcoma, Resection, Prognosis