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Abstract：
OBJECTIVE: Radical resection of retroperitoneal liposarcoma (RLPS) may necessitate vascular resection and reconstruction. The study was conducted to assess surgical outcomes of surgery for RLPS with major vascular involvement.
METHODS: Patients with RLPS who underwent surgical resection at the Sarcoma Center of Peking University Cancer Hospital between April 2011 and December 2022 were identified from a prospectively maintained database. Patients were classified into two groups: vascular resection and non-vascular resection groups. A propensity score matching analysis was performed to eliminate baseline differences between the groups. Surgical details and postoperative outcomes were analyzed. Furthermore, prognostic factors for local recurrence-free survival (LRFS) and overall survival (OS) were assessed.
RESULTS: Overall, 199 patients were identified and the median follow-up period was 48 (interquartile range [IQR] 45-69) months. Vascular resection was performed in 42 (21%) patients, 25 of whom had vascular infiltration. A total of 39 patients had vascular replacement and 3 patients underwent partial resection (side-wall resection). Vascular resection was burdened by higher rates of major morbidity (38% vs. 14%, p < 0.001) and 30-day mortality (7.1% vs. 1.3%, p = 0.005). After propensity-matched analysis, patients who underwent vascular resection had 5-year LRFS and OS rates comparable to those without vascular involvement. Major vascular resection was not an independent risk factor for LRFS or OS.
CONCLUSIONS: Although accompanied by increased risks of major morbidity and mortality, the major vascular resection enabled radical resection in patients with advanced RLPS, affording comparable 5-year LRFS and OS rates compared to those who did not.
METHODS: Patients with RLPS who underwent surgical resection at the Sarcoma Center of Peking University Cancer Hospital between April 2011 and December 2022 were identified from a prospectively maintained database. Patients were classified into two groups: vascular resection and non-vascular resection groups. A propensity score matching analysis was performed to eliminate baseline differences between the groups. Surgical details and postoperative outcomes were analyzed. Furthermore, prognostic factors for local recurrence-free survival (LRFS) and overall survival (OS) were assessed.
RESULTS: Overall, 199 patients were identified and the median follow-up period was 48 (interquartile range [IQR] 45-69) months. Vascular resection was performed in 42 (21%) patients, 25 of whom had vascular infiltration. A total of 39 patients had vascular replacement and 3 patients underwent partial resection (side-wall resection). Vascular resection was burdened by higher rates of major morbidity (38% vs. 14%, p < 0.001) and 30-day mortality (7.1% vs. 1.3%, p = 0.005). After propensity-matched analysis, patients who underwent vascular resection had 5-year LRFS and OS rates comparable to those without vascular involvement. Major vascular resection was not an independent risk factor for LRFS or OS.
CONCLUSIONS: Although accompanied by increased risks of major morbidity and mortality, the major vascular resection enabled radical resection in patients with advanced RLPS, affording comparable 5-year LRFS and OS rates compared to those who did not.
摘要：
目的：腹膜后脂肪肉瘤（RLPS）的根治性切除可能需要血管切除和重建。进行该研究以评估具有主要血管受累的RLPS的手术结果。
方法：2011年4月至2022年12月在北京大学肿瘤医院肉瘤中心接受手术切除的RLPS患者从前瞻性维护的数据库中进行鉴定。患者分为两组：血管切除组和非血管切除组。进行倾向评分匹配分析以消除组间的基线差异。分析手术细节和术后结果。此外，评估了无局部复发生存期(LRFS)和总生存期(OS)的预后因素.
结果：总体而言，199例患者被确定，中位随访期为48个月（四分位距[IQR]45-69）。42例（21%）患者行血管切除，其中25人血管浸润。共有39例患者进行了血管置换，3例患者进行了部分切除术（侧壁切除术）。血管切除的主要发病率较高(38%vs.14%,p<0.001）和30天死亡率（7.1%vs.1.3%,p=0.005)。经过倾向匹配分析，接受血管切除术的患者的5年LRFS和OS率与无血管受累的患者相当.大血管切除不是LRFS或OS的独立危险因素。
结论：尽管伴随着重大发病率和死亡率的风险增加，大血管切除使晚期RLPS患者能够进行根治性切除，与没有提供的5年期LRFS和OS费率相比，提供可比的5年期LRFS和OS费率。
方法：2011年4月至2022年12月在北京大学肿瘤医院肉瘤中心接受手术切除的RLPS患者从前瞻性维护的数据库中进行鉴定。患者分为两组：血管切除组和非血管切除组。进行倾向评分匹配分析以消除组间的基线差异。分析手术细节和术后结果。此外，评估了无局部复发生存期(LRFS)和总生存期(OS)的预后因素.
结果：总体而言，199例患者被确定，中位随访期为48个月（四分位距[IQR]45-69）。42例（21%）患者行血管切除，其中25人血管浸润。共有39例患者进行了血管置换，3例患者进行了部分切除术（侧壁切除术）。血管切除的主要发病率较高(38%vs.14%,p<0.001）和30天死亡率（7.1%vs.1.3%,p=0.005)。经过倾向匹配分析，接受血管切除术的患者的5年LRFS和OS率与无血管受累的患者相当.大血管切除不是LRFS或OS的独立危险因素。
结论：尽管伴随着重大发病率和死亡率的风险增加，大血管切除使晚期RLPS患者能够进行根治性切除，与没有提供的5年期LRFS和OS费率相比，提供可比的5年期LRFS和OS费率。
