原发性腹膜后平滑肌肉瘤术后生存期的相关性分析  

Prognostic factors predicting postoperative survival period in the treatment of primary retroperitoneal leiomyosarcoma

作　　者：赵旭东[1] 李沛雨[1] 黄晓辉[1] 陈凛[1] 李荣[1] 刘娜[1] 

机构地区：[1]解放军总医院普通外科,北京100853

出　　处：《中华外科杂志》2013年第10期891-894,共4页Chinese Journal of Surgery

摘　　要：目的 探讨影响原发性腹膜后平滑肌肉瘤术后生存期的因素.方法 回顾性分析2002年8月至2011年6月收治的35例原发性腹膜后平滑肌肉瘤患者的临床和预后资料.结果 32例（91.4％）患者经手术切除肿瘤,其中25例（71.4％）为根治性切除.在获得根治性切除患者中,21例（84.0％）复发并最终死于复发.中位生存时间为36个月,总体1、3、5年生存率分别为82.9％、54.3％和31.4％.在对患者术后生存期有影响的各因素中,手术方式（x2=16.871,P=0.000）、肿瘤最大径（x2=5.548,P=0.019）及肿瘤分级（x2=8.080,P =0.014）与患者术后生存时间相关；而性别（x2 =2.181,P=0.140）、年龄（x2=0.073,P=0.787）和辅助治疗（x2=1.344,P=0.511）对患者的预后无影响.结论 辅助治疗对腹膜后平滑肌肉瘤的治疗效果尚不明确,根治性手术仍是主要治疗手段.非根治性切除、肿瘤最大径≥10 cm及高级别肿瘤患者的术后生存期较短.Objective To evaluate prognostic factors predicting postoperative period for patients with primary retroperitoneal leiomyosarcoma.Methods Tbe clinical data and prognosis of 35 patients with primary retroperitoneal leiomyosarcoma between August 2002 and June 2011 were retrospectively reviewed and analyzed.Results The resectability rate of primary tumors was 91.4% （32/35）,and 71.4% （25/35） of the patients underwent complete resection.The 21 patients （84.0%） who got a complete resection of the primary tumor got tumor recurrence and died of tumor recurrence eventually.The overall 1-,3-,5-year survival rate were 82.9%,54.3% and 31.4% and the median survival was 36 mouths.In the analysis of factors influencing postoperative survival,factors associated with postoperative survive were modus operandi of the tumor resection （x2 =16.871,P =0.000）,tumor size （x2 =5.548,P =0.019） and tumor grade （x2 =8.080,P =0.014） ; the difference between age （x2 =0.073,P =0.787）,gender （x2 =2.181,P=0.140） and adjuvant therapy （x2 =1.344,P =0.511） got no statistical significance.Conclusions The efficiency of adjuvant therapy for primary retroperitoneal leiomyosarcoma is not clear,complete resection remains the mainstream for primary leiomyosarcoma.Incomplete resection,large tumor （tumor diameter ≥ 10 cm） and high grade tumor predict shorter postoperative survival period.

关 键 词：平滑肌肉瘤 腹膜后肿瘤 预后 

分 类 号：R735.4[医药卫生—肿瘤]