【作者】 刘宁；

【导师】 邱法波；

【作者基本信息】 青岛大学 ， 外科学， 2009， 硕士

【摘要】 目的:对原发性腹膜后肿瘤的手术相关因素进行分析并对患者进行随访,总结影响预后的因素。方法:回顾性分析青岛大学医学院附属医院2000年5月至2009年2月诊治的228例原发性腹膜后肿瘤患者的临床资料,并对患者进行随访。结果:228例原发性腹膜后肿瘤患者中208例行手术治疗,其中10例在我院行2次手术,4例行3次手术。病理结果恶性129例,良性79例。182例获得随访,随访时间1个月至8.3年,平均随访时间2.0±1.8年。良性肿瘤完整切除者术后1年、3年、5年生存率分别为97.4%、95.5%、81.8%,主要是其他疾病致死、车祸等意外死亡和正常衰老死亡;恶性肿瘤完整切除者术后1年、3年、5年生存率分别为90.0%、42.6%、25.6%,恶性肿瘤未完整切除者术后1年、3年、5年生存率分别为68.1%、14.9%、10.0%(P＜0.05)。经腹腔切除肿瘤患者有复发,平均无瘤生存时间为2.0±1.7年,复发者及未能完全切除者平均带瘤生存时间为8.7±9.4个月。Cox多因素回归显示:患者的性别与PRPT患者术后生存率有一定关系,男性略高于女性(RR=1.324,P＜0.05);术前有消瘦者生存率低,体重下降愈明显生存率愈低(RR=2.380,P＜0.01);生存率及复发率与肿块最大径(RR=1.004,P＜0.05)、是否侵犯其他脏器(RR=1.490,P＜0.05)、是否转移(RR=1.011,P＜0.05)、是否完整切除(RR=1.052,P＜0.05)、肿瘤的病理性质(RR=1.653,P＜0.01)和分化程度(RR=1.241,P＜0.05)密切相关。结论:影响PRPT预后的因素主要有患者是否伴有消瘦、肿瘤大小、是否侵犯其他脏器、是否转移、是否完整切除、病理性质和分化程度。充分做好原发性腹膜后肿瘤术前准备,提高肿瘤完整切除率,是降低原发性腹膜后肿瘤复发并提高其患者生存率的关键。更多还原

【Abstract】 Objective:To analyze the operation correlative factors of primary retroperitoneal tumor(PRPT),to do the follow-up visit,and to summarize the factors to influence PRPT’s prognosis.Method:The data of 228 cases with PRPT in The Affiliated Hospital of Qingdao University Medical College from May 2000 to February 2009 were reviewed retrospectively and did the follow-up visit of the patients.Results:Of 228 cases with PRPT,208 cases were surgically treated,including 10 cases with twice operations and 4 cases with three times operation.Among them,129 malignant and 79 benign were proved.182 cases were followed-up for 1 month to 8.3 years,and average follow-up time is 2.0±1.8 years.The 1-,3-,5-year survival rates of benign tumor in complete resection patients were 97.4%、95.5%、81.8%,respectively,whose causes of death were other lethal factors such as other disease、road accidents and normal ageing,those malignant tumor in complete resection were 90.0%、42.6%、25.6%,respectively,and those malignant tumor in imcomplete resection were 68.1%、14.9%、10.0%,respectively(P＜0.05).Those whose tumors were resected through transabdominal approach(TAA) recurred and had an average live time for 2.0±1.7 years.Those recurred and whose tumors were not completely resected had an average live time for 8.7±9.4 months.Cox multi-various regression analysis showed that the patients’ sexuality had something with the patients’ post-operation survival,in which male was higher than female(RR=1.324,P＜0.05).Those with emaciation had a lower survival rate,and the more whose body weight decreased,the lower survival(RR=2.380,P＜0.01).The longest diameter of tumor(RR=1.004,P＜0.05), encroachment on other organs(RR=1.490,P＜0.05),metastasis(RR=1.011,P＜0.05),incomplete tumor resection(RR=1.052,P＜0.05),the pathology nature(RR=1.653,P＜0.01) and histological grade(RR=1.241,P＜0.05) were closely associated with local recurrence and survival. organs,metastasis,incomplete tumor resection,the pathology nature and histological grade.Sufficient pre-operative preparation,and complete tumor resection are important roles for reducing recurrence and improving survival.更多还原