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目的总结原发性腹膜后肿瘤(PRPT)临床诊断治疗经验,分析影响PRPT手术效果和预后的因素。方法同顾性分析解放军总医院600例PRPT的临床诊断、手术治疗、疗效和预后。结果600例PRPT中546例行手术,肿瘤全部切除326例(占59.7%),肿瘤部分切除192例,肿瘤未切除取活检28例。同时行联合脏器切除手术113例(占20.7%)。PRPT完全切除组的1、3、5年生存率分别为:90.5%、73.2%、53.6%,恶性PRPT部分切除组的1、3、5年牛存率分别为:70.6%、32.0%、5.7%(P<0.01)。Cox多因素回归分析显示:PRPT的局部复发、生存期与(1)肿瘤是否完伞切除;(2)肿瘤大小;(3)肿瘤细胞的分化程度明显相关。结论充分做好PRPT手术前准备,提高肿瘤完全切除率,是降低PRPT肿瘤复发,提高生存率和预后的关键。
Objective To summarize the experience of clinical diagnosis and treatment of primary retroperitoneal tumor (PRPT) and analyze the factors affecting the outcome and prognosis of PRPT. Methods The clinical diagnosis, surgical treatment, curative effect and prognosis of PRPT in 600 PLA general hospitals were analyzed with the same direction. Results Of the 600 cases, 546 cases underwent PRT surgery. There were 326 cases (59.7%) of resected tumors, 192 partial tumor resections, and 28 cases without tumor resection. At the same time, 113 cases (20.7%) were performed the combined organ resection. The 1, 3, 5-year survival rates of the PRPT resection group were 90.5%, 73.2% and 53.6%, respectively. The 1, 3 and 5 year survival rates of the partially resected PRPT group were 70.6%, 32.0% and 5.7% % (P <0.01). Cox multivariate regression analysis showed that: PRPT local recurrence, survival and (1) the tumor is complete umbrella resection; (2) tumor size; (3) the degree of tumor cell differentiation was significantly correlated. Conclusions Proper PRT preoperative preparation and complete tumor resection rate are the keys to reduce PRPT tumor recurrence, improve survival rate and prognosis.