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学科主题: 肿瘤学
题名:
腹膜后脂肪肉瘤术后复发因素分析
作者: 王笑鹏
答辩日期: 2016-05-19
导师: 郝纯毅
专业: 肿瘤学
授予单位: 北京大学
授予地点: 北京大学临床肿瘤学院
学位: 硕士
关键词: 腹膜后脂肪肉瘤 ; 复发 ; 危险因素 ; 外科治疗
其他题名: Postoperative recurrence of retroperitoneal liposarcoma
分类号: R735.5
摘要:

背景与目的:腹膜后脂肪肉瘤(Retroperitoneal liposarcoma RPLS)是腹膜后肿瘤最常见的病种 [1]。腹膜后脂肪肉瘤起病隐匿,早期诊断困难,一旦发现往往瘤体较大。手术是目前首选的治疗方案,然而腹膜后脂肪肉瘤术后复发率很高,再次手术的挑战巨大[2,3,4]。本研究回顾性分析自2010年1月至2015年12月我中心诊疗的腹膜后脂肪肉瘤患者的临床资料及随访情况,分析影响腹膜后脂肪肉瘤术后复发的因素,并探讨其外科手术方式的选择对病人预后的影响,为寻找规范、合理的诊疗策略提供参考。

方  法:自2010年1月至2015年12月间共计40例腹膜后脂肪肉瘤患者就诊于北京大学肿瘤医院软组织与腹膜后肿瘤中心,回顾性分析患者的临床病理特征、外科治疗及预后情况,探讨影响肿瘤术后复发的因素。

结  果:本研究中40例患者共行手术75例次(本中心共计行45例次手术,患者于外院接受30例次手术)。联合脏器切除62例次,单纯肿物切除13例次。行腹膜后脂肪肉瘤肉眼完全切除58例次,肿瘤接受部分切除17例次(其中1例于我中心完成,其他16例均于外院完成)。有14例次依据扩大切除理念接受术治疗。单因素分析显示肿瘤的组织学分级和手术完整切除是影响腹膜后脂肪肉瘤复发的重要因素,联合周围脏器切除可明显提高肿瘤的完整切除率,从而降低肿瘤的术后复发率。

结   论:腹膜后脂肪肉瘤术后复发率很高,肿瘤的组织学分级和手术完整切除是影响腹膜后脂肪肉瘤术后局部复发的重要因素。联合周围脏器切除可明显提高肿瘤的完整切除率,术后肿瘤的局部复发率降低。依据肿瘤扩大切除理念接受手术治疗的病例与非扩大切除手术治疗的病例相较,同期(1年)术后局部复发率降低。

 

英文摘要:

Background: Retroperitoneal liposarcomas(RPLS)are rare cancers representing  20 %  of all retroperitoneum tumors. [1]. Tumors often grow to massive size prior to detection.The mainstay of treatment for RP STS is surgery with the goal of complete resection whenever possible [2, 3, 4].To investigate factors associated with postoperative recurrence of retroperitoneal liposarcoma and impacts of surgical patterns on patients ’outcome.

Methods: Clinicopathological acteristics and surgical management were reviewed retrospectively. Univariate analysis of factors with postoperative recurrence was performed.

Results:75operations were performed on all 40 cases with RPLS, which include 62  resections with involved organs and 13 simple tumor resections. Of these, 45 operations were performed at our sarcoma center while the other 30 in other institutions. Gross complete resection was achieved in 58 operations. Of the 17 partial resections, only one was performed at our center. 14 extended resections were completed according to the theory of extended surgery. Univariate analysis revealed that histological grade and gross complete resection by surgery were important factors impacting the recurrence of RPLS. Resections with involved organs could improve complete resection rate with lower postoperative recurrence rate. 1-year postoperative recurrence rate in patients who underwent extended resections was significantly lower than that in non-extended resectios.

Conclusions: RPLS has a high postoperative recurrence rate. Tumor histological grade and gross complete resection are independent factors affecting recurrence-free survival in RPLS[5].Resections with involved organs could improve complete resection rate with lower postoperative recurrence rate.

 

语种: 中文
相关网址: 查看原文
内容类型: 学位论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/125696
Appears in Collections:北京大学临床肿瘤学院_学位论文

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作者单位: 北京大学临床肿瘤学院

Recommended Citation:
王笑鹏. 腹膜后脂肪肉瘤术后复发因素分析[D]. 北京大学临床肿瘤学院. 北京大学. 2016.
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