98例成人原发性腹膜后恶性肿瘤的诊治分析

目的探讨成人原发性腹膜后恶性肿瘤（APRMT）的诊断方法和手术经验。方法对1990年1月至2003年4月经手术治疗的98例APRMT患者的临床资料进行分析。结果98例成人原发性腹膜后恶性肿瘤中,肿瘤完全切除79例（80．6％）,姑息性切除16例（16．3％）,肿瘤探查和单纯活检3例（3．1％）,合并脏器切除25例（25．5％）;复发再次手术者28例（28．6％）。肿瘤完全切除的79例患者的1、3、5年生存率分别为93．7％、73．4％和34．2％,姑息性切除的1、3、5年生存率分别为75．O％、6．3％和6．3％。结论联合应用合理的影像学检查对判断APRMT肿瘤周围器官是否受累和切除范围有重要意义,充分的术前准备和受累器官的联合切除可以提高APRMT切除率和预后,对于复发病例,应争取尽早再次手术治疗。

Diagnosis and surgical treatment of 98 cases with adult primary retroperitoneal malignant tumor

OBJECTIVE: To investigate the diagnosis and surgical treatment of adult primary retroperitoneal malignant tumor (APRMT). METHODS: The clinical data of 98 cases with APRMT underwent resection from January 1990 to April 2003 were analyzed retrospectively. RESULTS: Among the 98 cases, complete excision were performed in 79 cases (80.6%), palliative excision in 16 cases (16.3%), tumor biopsy only in 3 cases (3.1%). Resection of involved adjacent organs were carried out in 25 cases (25.5%) and the re-operation rate for recurrence was 28.6% (28 cases). The 1, 3, 5 year survival rates for 79 cases with complete resection were 93.7%, 73.4% and 34.2%, respectively. The 1, 3, 5 year survival rate for 16 cases with palliative resection were 75.0%, 6.3% and 6.3%, respectively. CONCLUSIONS: Certain imaging examinations are crucial to the diagnosis and preoperative evaluation of APRMT. Resection of the involved organs could improve resection rate and prognosis. For the recurrent cases, earlier reoperation is strongly recommended.