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題名 | Surgical Management of Primary Retroperitoneal Sarcoma=原發性後腹腔肉瘤之手術處理 |
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作者 | 王泰元; 羅世薰; 蘇正熙; 吳秋文; 雷永耀; | 書刊名 | 中華醫學雜誌 |
卷期 | 58:3 1996.09[民85.09] |
頁次 | 頁177-182 |
分類號 | 416.242 |
關鍵詞 | 完全切除; 無疾病間隔; 後腹腔肉瘤; Complete resection; Disease-free interval; Retroperitoneal sarcoma; |
語文 | 英文(English) |
中文摘要 | 背景 後腹腔肉瘤對外科醫師來說是一群相當稀少及富挑戰性的疾 病,它具有廣泛性生長及高復發率,我們分析我們的病人來確定可以增加存活 率的因素。 方法 從1971年至1993年對40位原發性後腹腔肉瘤病人的病歷加以回顧, 看臨床因素包括年齡、性別、腫瘤大小、組織病理形態、手術方式、無疾病間 隔,及手術次數是否與病人存活率相關。 結果 大部分病人以巨大腹部腫瘤為臨床表現,其中22位是脂肪肉瘤,8位 是平滑肌肉瘤,5位是惡性纖維組織細胞瘤,2位是纖維肉瘤,2位是惡性間葉 瘤及1位橫紋肌肉瘤,28位病人接受完全手術切除,12位接受不完全切除,完 全手術切除病人明顯有較好的存活率(P值=0.0001),19位接受完全手術切除病 人有腫瘤復發,復發率為68%,無疾病間隔大於12個月的病人明顯比小於12 個月病人有較好存活率(P值=0.005),對復發腫瘤採取積極手術切除,接受過大 於2次( >= 3)手術病人明顯比小於2次手術病人有較好存活率(P值=0.0247)。 結論 在我們分析中,完全手術切除及積極性重覆手術處理是最有效的治療方 法。 |
英文摘要 | Background. Retroperitoneal sarcoma is a rare and challenging group of diseases for surgeons, characterized by extensive growth and high recurrent rate. We analyzed data from our patients to identify the factors of survival. Methods. From 1971 to 1993, medical records of 40 patients with primary retroperitoneal sarcoma were reviewed. Clinical factors including age, sex, tumor size, histopathology, type of operation, disease-free interval, and number of operation were collected to correlate with patient's survival. Results. Most patients presented with huge abdominal mass. There were 22 liposarcomas, 8 leiomyosarcomas, 5 malignant fibrous histiocytomas, 2 fibrosarcomas, 2 malignant mesenchymomas and one rhabdomyosarcoma. Twenty-eight patients received complete resection and 12 had incomplete resection. The group with complete resection showed a better survival than incomplete resection group (p = 0.0001). Nineteen patients with complete resection had tumor recurrence. The recurrent rate was 68%. Patients having been disease-free for more than 12 months showed to have better survival than those less than 12 months (p = 0.005). Aggressive surgical resection was done in case of tumor recurrence. Patients who received more than 2 ( >= 23) operations also showed a better survival than those with less than 2 operations (p = 0.0247). Conclusions. Complete surgical resection and aggressive repeated surgical intervention are the most effective treatment modality for better survival in patients with retroperitoneal sarcoma. |
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