腹膜后肿瘤联合左侧脏器切除的临床特点及预后  

Clinical features and prognosis of retroperitoneal tumours combined with left-sided organ removal:a single institution experience with 55 cases

作　　者：王康伟 张洪强 屈国伦 王洪波 曲兴龙 陈勇[2] Wang Kangwei;Zhang Hongqiang;Qu Guolun;Wang Hongbo;Qu Xinlong;Chen Yong(Department of Oncosurgery,Minhang Branch,Shanghai Cancer Hospital,Fudan University,Shanghai 200240,China;Department of Bone and Soft Tissue Tumour Surgery,Affiliated Cancer Hospital of Fudan University,Shanghai 200240,China)

机构地区：[1]复旦大学附属肿瘤医院闵行分院肿瘤外科,上海200240 [2]复旦大学附属肿瘤医院骨与软组织肿瘤外科,上海200032

出　　处：《中华临床医师杂志(电子版)》2024年第10期906-912,共7页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的探讨左侧腹膜后肿瘤联合腹腔脏器切除术患者的临床特征及预后影响因素。方法回顾性分析2016年12月至2022年12月在复旦大学附属肿瘤医院闵行分院肿瘤外科行左侧腹膜后肿瘤切除联合脏器切除术的55例患者的临床资料,分析患者的临床特征、手术方式、总生存时间及无复发生存时间,采用Kaplan-Meier曲线进行生存分析,并构建Cox回归模型分析探索左侧腹膜后肿瘤联合脏器切除术后患者远期预后的影响因素。结果55例患者均完整切除肿瘤,中位年龄60(17~84)岁,中位肿瘤直径16(6~45)cm,中位随访时间26个月(3~73)月,术后Clavien Dindo并发症分级Ⅲ级发生率为14.5%(8/55),1、3、5年生存率分别为87.2%、83.5%、70.3%;1、3、5年无复发生存率分别为80.0%、58.6%、44.0%。Cox单因素和多因素分析显示:50例恶性肿瘤患者中仅病理分级和肿瘤直径是影响患者预后的因素;而年龄、性别、是否首次手术、病例类型、联合器官切除数、术中出血量均不是影响患者预后的因素。55例患者中仅病理分级和是否首次手术是影响患者无复发生存期预后的因素;而年龄、性别、肿瘤直径、病例类型、联合器官切除数、术中出血量均不是影响患者无复发生存期预后的因素。结论腹膜后肿瘤联合左侧腹腔脏器切除术有利于腹膜后肿瘤的完整切除,术后并发症可控。病理分级和肿瘤直径是患者预后的危险因素,术后病理分级和是否首次手术是患者无复发生存预后的危险因素。Objective To investigate the clinical characteristics and prognostic factors of patients undergoing left-sided retroperitoneal tumour resection combined with organ resection.Methods The clinical data of 55 patients who underwent left-sided retroperitoneal tumour excision combined with organ resection in the Department of Surgical Oncology of Minhang Branch of Fudan University Cancer Hospital were retrospectively analysed from December 2016 to December 2022.The clinical characteristics,surgical modalities,overall survival(OS),and recurrence-free survival(RFS)of the patients were analysed.Kaplan-Meier curves were used for survival analysis.Cox regression analysis was used to explore the factors influencing patients’long-term prognosis after left-sided retroperitoneal tumour resection combined with organ resection.Results All the 55 patients achieved complete resection of the tumour.Their median age was 60(range,17~84)years.Median tumour diameter was 16(range,6~45)cm.Median follow-up time was 26(range,3~73)months.The incidence of postoperative Clavien-Dindo grade III complications was 14.5%(8/55).The 1-,3-,and 5-year OS rates were 87.2%,83.5%,and 70.3%,respectively,and the 1-,3-,and 5-year RFS rates were 80.0%,58.6%,and 44.0%,respectively.Cox univariate and multivariate analyses showed that only pathological grade and tumour diameter were factors affecting the prognosis of the patients,whereas age,gender,being operated for the first time or not,case type,number of combined organ resections,and intraoperative bleeding were were not.Only pathological grade and being operate for the first time or not were factors affecting the RFS of patients,while age,gender,tumour diameter,case type,number of combined organ resections,and amount of intraoperative bleeding were not.Conclusion Left-sided retroperitoneal tumour resection combined with organ resection facilitates complete resection of the retroperitoneal tumour with manageable postoperative complications.Pathological grade and tumour diameter are risk factors for patie

关 键 词：腹膜后肿瘤 脏器切除 联合脏器切除 外科治疗 预后 

分 类 号：R735[医药卫生—肿瘤]