后腹腔软组织肉瘤的手术与预后影响因素的分析  

Retroperitoneal soft tissue sarcoma:analysis of surgery approaches and prognostic risk factors

作　　者：周红华[1,2] 程继文[2] 蒙清贵[2] 陆浩源[2] 白先忠[2] 

机构地区：[1]九江学院附属医院外五科,江西九江332000 [2]广西医科大学附属肿瘤医院泌尿外科,广西南宁530021

出　　处：《现代泌尿外科杂志》2014年第11期732-736,共5页Journal of Modern Urology

摘　　要：目的探讨后腹腔软组织肉瘤(RSTS)的手术预后相关因素。方法回顾广西医科大学附属肿瘤医院从2002年1月至2013年10月住院的腹膜后肿瘤手术患者,应用SPSS16.0统计软件,总生存率(OS)、无病生存率(DFS)和无进展生存率(PFS),复发率(LRR)及生存率分析采用Kaplan-Meier法和Log-rank检验进行单因素分析预后分析,多因素分析采用Cox回归,P<0.05为差异有统计学意义。结果完整切除术后1、3、5年LRR分别为26.7%、86.7%、100%,复发中位时间17.5月;1、3、5OS分别为100%、93.3%、40%,中位生存时间56月;1年、3年DFS 83.4%、33.4%。单因素分析肿瘤分层、大小、切缘、分化程度、AJCC分期、手术方式是患者预后的影响因素,但Cox回归分析提示:手术方式(P=0.045)与AJCC分期(P=0.05)是复发率的影响因素,是否复发(P=0.013)、手术方式(P=0.015)、切缘(P=0.049)、分化程度(P=0.002)、AJCC分期(P=0.020)是影响生存率的危险因素。结论手术方式、切缘、分化程度、AJCC分期是影响手术预后的重要因素,相关预后因素值得进一步探讨。Objective To explore the prognostic factors of retroperitoneal soft tissue sarcoma （RSTS） ,in order to reduce local recurrence rate ,improve disease‐free survival and overall survival .Methods Clinical data of 71 cases of retroperitoneal soft‐tissue sarcoma underwent surgery in Guangxi Medical University Affiliated Tumor Hospital during Jan .2002 and Oct .2013 were retrospectively reviewed .All data were analyzed using SPSS16 .0 statistic software .Overall survival ,disease‐free survival , progress‐free survival and local recurrence rate were calculated with Kaplan‐Meier methods and Log‐rank test .Multivariate a‐nalysis was calculated with a Cox proportional hazards regression model .Results The local recurrence rate 1‐year ,3‐year and 5‐year was 26 .7% ,86 .7% and 100% ,with a median follow‐up recurrence time of 17 .5 months .The overall survival was 100% ,93 .3% and 40% ,median overall survival time being 56 months .The 1‐year and 3‐year disease‐free survival was 83 .4%and 33 .4% .Univariate analysis revealed that the factors impacting the prognosis were primary or recurrence cases ,tumor size , positive or negative surgical margin ,differentiated degree ,AJCC stage and surgical approaches .The Cox regression multivari‐ate analysis showed that only surgical approaches （P=0 .045） and AJCC stage （P=0 .05） had significant influence on local re‐currence rate ;recurrence rate （P=0 .013） ,surgical margin （P=0 .049） ,surgical approaches （P=0 .015） ,differentiated de‐gree （P=0 .002） and AJCC stage （P=0 .020） were prognostic risk factors on overall survival .Conclusions The prognostic factors were greatly associated with surgical margin ,AJCC stage ,differentiated degree and surgical approaches ,which are worthy of further clinical investigation .

关 键 词：后腹腔软组织肉瘤 手术方式 预后 复发率 

分 类 号：R725.9[医药卫生—儿科]