原发性腹膜后平滑肌肉瘤初次术后影响生存期的因素分析  

Analysis of factors affecting survival after initial surgery on primary retroperitoneal leiomyosarcoma

作　　者：邹博远 高海成 李文杰 陈小兵 黄梅 苗成利[1] ZOU Boyuan;GAO Haicheng;LI Wenjie;CHEN Xiaobing;HUANG Mei;MIAO Chengli(Department of Retroperitoneal Tumor 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》2024年第1期40-44,共5页Chinese Research Hospitals

摘　　要：目的分析初次手术后对原发性腹膜后平滑肌肉瘤患者生存期的影响因素,并了解其临床特征。方法搜集2018年1月—2023年1月67例原发性腹膜后平滑肌肉瘤患者的临床资料进行回顾性分析。根据患者的手术情况、年龄、性别、病理类型及其他相关因素,对其生存期进行统计和分析。符合正态分布的计量资料以xˉ±s表示、采用t检验;计数资料以%表示、采用χ2检验。对影响患者预后因素的分析采用单因素分析,其中差异有统计学意义的因素采用多因素Logistic回归分析。结果67例患者的平均生存期为(18.25±2.41)个月,病理证实肿瘤类型均为平滑肌肉瘤。生存分析显示,年龄>60岁、肿瘤最大径>10 cm、肿瘤分期Ⅲ~Ⅳ期、肿瘤分化程度低~差、肿瘤累及其他脏器均是影响患者术后生存期的危险因素(P均<0.05);性别、体质量指数、吸烟史、饮酒史、手术方式对患者的生存期无明显影响(P均>0.05)。经多因素Logistic回归分析,表明年龄≥60岁、显微镜下切缘看到肿瘤细胞(R1切除)、肿瘤最大径≥10 cm、肿瘤分期Ⅲ~Ⅳ期、肿瘤低~差分化、肿瘤累及其他脏器均是影响原发性腹膜后平滑肌肉瘤初次手术后生存率的独立危险因素。结论患者年龄、肿瘤最大径、肿瘤分期等是影响患者预后的主要因素,准确评估这些影响因素有助于指导临床决策,进一步改善患者的预后结果。Objective To analyze the actors influencing the survival of patients with primary retroperitoneal leiomyosarcoma after the initial surgery and understand their clinical characteristics.Methods Clinical data of 67 patients with primary retroperitoneal leiomyosarcoma from 2018 to 2023 were collected for retrospective analysis.The survival period was statistically analyzed based on patient's surgical situation,age,gender,pathological type,and other relevant factors.Measurement data conforming to a normal distribution were expressed as xˉ±s and analyzed using t-test;count data were expressed as percentages and analyzed using theχ2 test.Univariate analysis was used for factors affecting patient prognosis,and factors with statistically significant differences were further analyzed using multivariate logistic regression analysis.Results Among the 67 patients,the average survival period was(18.25±2.41)months,and pathological confirmation indicated leiomyosarcoma in all cases.Survival analysis showed that age>60 years,tumor size>10 cm,tumor stageⅢ-Ⅳ,low to poor tumor differentiation,and tumor involvement of other organs(all P<0.05)were risk factors affecting the postoperative survival period of patients.Gender,body mass index,smoking history,drinking history,and surgical approach did not significantly affect patient survival(all P>0.05).Multivariate logistic regression analysis indicated that age≥60 years,microscopic positive surgical margins(R1 resection),tumor size≥10 cm,tumor stageⅢ-Ⅳ,low to poor tumor differentiation,and tumor involvement of other organs were independent risk factors affecting the postoperative survival rate of primary retroperitoneal leiomyosarcoma.Conclusion Patient age,tumor size,and tumor stage are major factors affecting prognosis,and accurately assessing these influencing factors can guide clinical decision-making and further improve patient prognosis.

关 键 词：腹膜后肿瘤 平滑肌肉瘤 外科手术 预后 影响因素 

分 类 号：R735.4[医药卫生—肿瘤]