原发性腹膜后肿瘤的治疗及预后分析

目的探讨外科手术治疗原发性腹膜后肿瘤的方法和影响患者预后的因素。方法回顾分析2002年5月-2008年5月收治的70例原发性腹膜后肿瘤患者的临床表现、影像学检查、手术治疗及随访情况。结果 70例患者均进行了手术治疗,其中良性肿瘤20例（28.57%）,恶性肿瘤50例（72.43%）,良恶之比为1∶2.5;完整切除肿瘤者58例（82.86%）,肿瘤部分切除者7例（10%）,肿瘤广泛转移行组织活检者5例（7.14%）,联合器官切除者18例（25.71%）。术后随访1～5年恶性肿瘤患者45例,其中肿瘤完全切除组1、3、5年的生存率分别为91.67%、66.67%、22.22%,肿瘤部分切除组分别为66.67%、33.33%、0%。两组比较差异有统计学（P〈0.01）。研究发现肿瘤的大小、病理类型、是否完整切除是影响肿瘤局部复发、患者生存率的重要因素。结论早期诊断、充分的术前准备、肿瘤的全切除率能显著改善患者术后远期生存率。

Treatment and Prognosis of Primary Retroperitoneal Tumor

Objective To investigate the surgical management for primary retroperitoneal tumors（PRT）and the factors influencing the prognosis after operation.Methods The clinical manifestation,image data,treatment and prognosis of 70patients with primary retroperitoneal tumor from May 2002to May 2008 were retrospectively analyzed.Results All of the patients with PRT had undergone the operations,in whom 20（28.57%）had benign tumors and 50（72.43%）had malignant tumors with a ratio of 1：2.5.Among these patients,58（82.86%）had complete resection,7（10%）had incomplete resection,five（7.14%）had surgical biopsies and 18（25.71%）had combined resection of the organs.A total of 45patients with malignant tumors were followed up for one month to five years.The one-,three-,and five-year survival rates of the patients in complete resection group was 91.67%,66.67% and 22.22%,respectively;and was 66.67%,33.33%,and 0%,respectively in incomplete resection group.The differences between the two groups were significant（P0.001）.The results showed that the completeness of tumor, sizes,and histological type were associated closely with local recurrence and prognosis.Conclusion Early diagnosis, sufficient preoperative preparation and complete tumor resection play important roles in reducing the recurrence and improving the long-term survival rate.