Retroperitoneal soft-tissue sarcoma - Analysis of 500 patients treated and followed at a single institution
Retroperitoneal soft-tissue sarcoma - Analysis of 500 patients treated and followed at a single institution
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DOI：
10.1097/00000658-199809000-00008
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发表时间：
1998-09-01
影响因子：
9
通讯作者：
Brennan, MF
中科院分区：
文献类型：
--
作者：
Lewis, JJ;Leung, D;Brennan, MF
目的分析一个大型队列的腹膜后软组织肉瘤（STS）患者治疗和前瞻性随访在一个单一institution.Summary背景数据腹膜后STS是相对罕见的，构成了一个困难的管理问题，虽然手术切除往往是困难的或不可能的，目前的化疗是无效的，放射治疗是有限的毒性相邻结构。因此，完整的手术切除仍然是最有效的方式为选定的原发性和复发性diseases.Methods 500例腹膜后STS收治和治疗之间的1982年7月1日，1997年9月30日，并进行前瞻性随访。分析患者、肿瘤和治疗变量的疾病特异性和无病生存期。生存期用Kaplan-Meier方法确定。单因素影响采用log-rank检验，多因素影响采用考克斯模型逐步回归分析。结果原发病278例（56%），复发病222例（44%）。中位随访时间为28个月（范围1至172个月），存活者为40个月。原发病患者的中位生存期为72个月，局部复发患者为28个月，转移患者为10个月。对于原发性或局部复发性肿瘤，不可切除的疾病，不完全切除，高级别肿瘤的患者显着降低生存时间。结论在这项研究中，腹膜后STS，在介绍阶段，高组织学分级，不可切除的原发性肿瘤，和积极的毛利与肿瘤死亡率密切相关。有治愈意图的患者应积极尝试完全手术切除。只有在症状缓解时才应进行不完全切除。
Objective To analyze treatment and survival of a large cohort of patients with retroperitoneal soft-tissue sarcomas (STS) treated and prospectively followed at a single institution.Summary Background Data Retroperitoneal STS are relatively uncommon and constitute a difficult management problem, Although surgical resection is often difficult or impossible, current chemotherapy is not effective and radiation is limited by toxicity to adjacent structures. Thus, complete surgical resection remains the most effective modality for selected primary and recurrent disease.Methods Five hundred patients with retroperitoneal STS were admitted and treated between July 1, 1982, and September 30, 1997, and prospectively followed. Patient, tumor, and treatment variables were analyzed for disease-specific and disease-free survival, Survival was determined with the Kaplan-Meier method. Statistical significance was evaluated using the log-rank test for univariate influence and Cox model stepwise regression for multivariate influence.Results Two hundred seventy-eight patients (56%) had primary disease and 222 (44%) recurrent disease. Median follow-up was 28 months (range 1 to 172 months), 40 months for survivors. Median survival was 72 months for patients with primary disease, 28 months for those with local recurrence, and 10 months for those with metastasis. For patients with primary or locally recurrent tumors, unresectable disease, incomplete resection, and high-grade tumors significantly reduced survival time.Conclusions In this study of patients with retroperitoneal STS, stage at presentation, high histologic grade, unresectable primary tumor, and positive gross margin are strongly associated with the tumor morality rate. Patients approached with curative intent should undergo aggressive attempts at complete surgical resection. incomplete resection should be undertaken only for symptom relief.