腹膜后脂肪肉瘤术后多次复发的危险因素分析  

Analysis of risk factors for post operative multiple recurrence of retroperitoneal liposarcoma

作　　者：刘文庆 唐茂盛 邹博远 黄梅 苗成利[1] LIU Wenqing;TANG Maosheng;ZOU Boyuan;HUANG Mei;MIAO Chengli(Department of Retroperitoneal Tumour Surgery,Peking University International Hospital,Beijing 102206,China)

机构地区：[1]北京大学国际医院腹膜后肿瘤外科,北京102206

出　　处：《中国研究型医院》2022年第4期18-23,共6页Chinese Research Hospitals

基　　金：北京市科委课题(Z161100000516025);北京大学国际医院院内重点课题(YN2021ZD04)。

摘　　要：目的探讨复发性腹膜后脂肪肉瘤(RPLS)患者多次复发的危险因素。方法搜集2018年1月—2021年12月123例经术后病理确诊为RPLS,复发≥1次且接受手术的患者的病例资料进行回顾性研究。按照结局事件是否再次复发,将患者分为再次复发组(Rrec组)44例和未再次复发组(NRrec组)79例;调查两组的年龄、性别、手术次数、肿瘤最大径、手术时间、出血量、输注红细胞量、输注血浆量、肉眼完整切除(R1)、R1+全腹膜后脂肪清扫(R1+TRFD)、姑息性术中残留切除(R2)+多柔比星脂质体+异环磷酰胺(AI方案)补救性化疗治疗(R2+AI)、病理类型(高分化、去分化、黏液性、多形性)与可能多次复发相关因素进行单因素分析,对具有显著差异的变量纳入多因素Logistic回归,分析复发的独立危险因素。结果在P<0.10显著性水平下,R1共101例、R2+AI共22例、手术时间(290.0±128.7)min,在RPLS是否复发上差异具有统计学意义;性别、R1+TRFD共23例、病理类型、年龄、手术次数、肿瘤最大径、出血量、输注红细胞、输注血浆在是否复发上差异无统计学意义。R1(OR=6.856,P=0.006)及手术时间(OR=1.005,P=0.010)均为RPLS多次复发的独立危险因素。结论R1切除及手术时间是RPLS术后多次复发的独立危险因素。Objective To investigate the risk factors for multiple recurrences in patients with recurrent retroperitoneal liposarcoma(RPLS).Methods Case data of 123 patients with postoperative pathologically confirmed RPLS with≥1 recurrence and undergoing surgery from January 2018 to December 2021 were collected for a retrospective study.Patients were divided into 44 cases in the recurrence group(Rrec group)and 79 cases in the non-recurrence group(NRrec group)according to whether the outcome event was a recurrence.The age,gender,number of operations,maximum tumour diameter,operation time,bleeding volume,red blood cell transfusion volume,plasma transfusion volume,complete resection by the naked eye(R1),complete resection by the naked eye+total retroperitoneal fat dissection(R1+TRFD).Palliative incomplete resection(R2)+liposomal doxorubicin+Ifosfamide(AI group)is remedial chemotherapy(R2+AI group).Pathological type(high differentiation,dedifferentiation,mucinous and pleomorphic),was analyzed for independent risk factors for recurrence by univariate analysis with factors associated with possible multiple recurrences,and variables with significant differences were included in a multifactorial logistic regression.Results At the P<0.10 level of significance,the differences in whether RPLS recurred were statistically significant for R1 in a total of 101 cases,R2+AI in a total of 22 cases,and operative time(290.0±128.7)min;the differences in whether RPLS recurred were not statistically significant for gender,R1+TRFD in a total of 23 cases,pathological type,age,number of operations,maximum tumour diameter,bleeding volume,red blood cell transfusion,and plasma transfusion R1(OR=6.856,P=0.006)and operation time(OR=1.005,P=0.010)were both independent risk factors on recurrence.Conclusion R1 resection and operation time are independent risk factors for post operative multiple recurrences of RPLS.

关 键 词：腹膜后肿瘤 脂肪肉瘤 复发 LOGISTIC模型 

分 类 号：R735.4[医药卫生—肿瘤]