75例腹膜后软组织肉瘤的临床分析

目的　分析腹膜后软组织肉瘤的预后和放射治疗作用。方法　 75例中 ,5 0例为首程治疗 ,2 5例为局部复发后再治疗。 5 0例初治患者均接受手术治疗 ,其中 13例接受术后放射治疗。 2 5例外院术后复发再治疗患者有 16例接受手术 ,其中 3例接受术后放射治疗 ,另 9例接受单纯放射治疗。结果　全组、初程和复发再治疗患者的 5年总生存率分别为 39%、4 0 %和 37%。全组患者手术完整切除、部分切除和未切除的 5年生存率分别为 5 2 .7%、36 .6 %和 0 % ;完整切除和部分切除或未切除的生存率间差异有显著性意义 (P值分别为 0 .0 0 7、0 .0 0 0 ) ,但部分切除与未切除的 5年生存率间差异无显著性意义 (P =0 .196 )。手术完整切除的 4 1例患者 ,未放射治疗和放射治疗的 5年局部复发率分别为4 7%和 6 0 % (P =0 .880 ) ,5年生存率分别为 5 1%和 6 0 % (P =0 .780 )。手术部分切除和未切除的 2 5例患者 ,未放射治疗和放射治疗的 5年生存率分别为 17%和 4 4 % (P =0 .15 1)。结论　腹膜后软组织肉瘤的治疗以手术为主 ,手术完整切除可显著提高生存率。常规体外放射治疗的作用尚不肯定

Clinical analysis of 75 primary and recurrent retroperitoneal soft tissue sarcoma

Objective To assess the outcome of patients with retroperitoneal soft tissue sarcoma treated with surgery and external radiotherapy. Methods From 1958 to 1998, 50 patients with untreated retroperitoneal soft tissue sarcoma and 25 patients with recurrent disease were treated at our institution. All 50 initially treated patients received surgery, among whom 13 were given postoperative radiotherapy. For the 25 recurrent patients, 16 received surgery, among whom 3 received postoperative radiotherapy. Nine other patients received radiotherapy alone. Results The 5-year actuarial overall survival (OS) rates of all patients, untreated and recurrent patients were 39%, 40% and 37%. The 5-year OS rates were 52.7%, 36.6% and 0% for patients with complete resection, partial resection and biopsy only, with improved survival for complete resection as compared with partial resection or biopsy (P=0.007, P=0.000), though without significant difference between the latter two (P= 0.196 ). In 41 patients with complete resection, the 5-year OS was 51% for unirradiated patients in comparison with 60% for irradiated ones, still without survival benefit (P=0.780). The 5-year local recurrence rates were 47% and 60% for unirradiated and irradiated patients with the difference insignificant (P=0.880). In 25 patients with partial resection or biopsy only, the 5-year OS was 17% for unirradiated patients in comparison with 44% for irradiated patients without significant systematic change (P=0.151). Conclusions Surgery remains the radical treatment modality of choice in patients with retroperitoneal soft tissue sarcoma and complete resection may afford the best survival. The value of conventional external radiotherapy needs further study.