腹膜后脂肪肉瘤术后复发因素分析  

Clinicopathological risk factors of retroperitoneal liposarcoma recurrence-free survival after surgical resection

作　　者：庄奥博 吴茜 王炯元[1,2] 徐静[1,2] 童汉兴[1,2] 张勇[1,2] 陆维祺[1,2] Zhuang Aobo;Wu Qian;Wang Jiongyuan;Xu Jing;Tong Hanxing;Zhang Yong;Lu Weiqi(Department of General Surgery,South Hospital of the Zhongshan Hospital/Shanghai Public Health Clinical Center,Fudan University,Shanghai 201508,China;Department of General Surgery,Zhongshan Hospital,Fudan University,Shanghai 200032,China)

机构地区：[1]上海市(复旦大学附属)公共卫生临床中心普外科,复旦大学附属中山医院南院普外科,上海201508 [2]复旦大学附属中山医院普通外科,上海200032

出　　处：《中华普通外科杂志》2021年第10期766-769,共4页Chinese Journal of General Surgery

摘　　要：目的探讨腹膜后脂肪肉瘤术后复发的预后因素。方法采用回顾性病例对照研究方法,选取2014年7月—2020年6月在复旦大学附属中山医院南院普外科收治的271例腹膜后脂肪肉瘤患者。结果本组271例腹膜后脂肪肉瘤患者中127例(46.9%)术后复发,144例(53.1%)未发生复发。复发组患者术前评估为复发性病例的患者更多(χ^(2)=15.289,P<0.05)、肿瘤侵犯脏器的比例更高(χ^(2)=10.123,P<0.05)、FNCLCC分级更高(χ^(2)=7.650,P<0.05)。全体患者的中位随访时间为25个月(1~58个月)。1、2、3年的无复发生存率分别为61.4%、40.3%、30.9%。单因素分析结果提示,复发性疾病、脏器侵犯、分化差的病理类型及高FNCLCC分级均是术后复发的不良预后因素(均P<0.05);多因素分析结果显示,复发性疾病(OR=3.135,95%CI:2.058~4.762,P<0.05)、脏器侵犯(OR=2.577,95%CI:1.214~5.464,P<0.05)及高FNCLCC分级(P<0.05)是术后复发的独立预后因素。结论疾病状态、脏器侵犯及FNCLCC分级是腹膜后脂肪肉瘤术后复发的独立预后因素。Objective To explore the clinicopathological risk factors of retroperitoneal liposarcoma recurrence-free survival after surgical resection,and establish a prediction model based on clinicopathological risk factors.Methods We conducted a retrospective analysis for retroperitoneal liposarcoma patients undergoing surgical resection at Department of General Surgery,Shanghai Public Health Clinical Center,Zhongshan Hospital(South),Fudan University,during Jul 2014 and Jun 2020.The clinical and pathological data were collected.Univariate and multivariate analysis were used to select independent risk factors.Result A total of 271 patients were included,and 127(46.9%)were recurred.In the recurrence group,more patients were assessed as recurrent disease(χ^(2)=15.289,P<0.05),the proportion of tumors invading organs was higher(χ^(2)=10.123,P<0.05),and FNCLCC graded higher(χ^(2)=7.650,P<0.05).The median follow-up time for all patients was 25 months(1-58 months).The 1,2,and 3-year recurrence-free survival rates were 61.4%,40.3%,and 30.9%,respectively.Univariate analysis suggests that recurrent disease,organ invasion,poorly differentiated pathological types,and high FNCLCC grades are poor prognostic factors for postoperative recurrence(all P<0.05);Multivariate analysis showed that recurrent disease(OR=3.135,95%CI:2.058-4.762,P<0.05),organ invasion(OR=2.577,95%CI:1.214-5.464,P<0.05)and high FNCLCC grade(P<0.05)is an independent prognostic factor for postoperative recurrence.Conclusion Presentation status,FNCLCC grade and organ invasion were independent risk factors for retroperitoneal liposarcoma recurrence after surgery.

关 键 词：脂肪肉瘤 腹膜后肿瘤 复发 预后 

分 类 号：R735.4[医药卫生—肿瘤]