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Abstract：
BACKGROUND: Retroperitoneal liposarcoma (RLPS) constitutes the majority of retroperitoneal sarcomas. While surgical resection remains the sole curative approach, determining the optimal surgical strategy for RLPS remains elusive. This study addresses the ongoing debate surrounding the optimal surgical strategy for RLPS.
METHODS: We recruited 77 patients with RLPS who underwent aggressive surgical policies. Patients were categorized into three surgical subtypes: suprapancreatic RLPS, pancreatic RLPS, and subpancreatic RLPS. Our standardized surgical strategy involved resecting macroscopically uninvolved adjacent organs according to surgical subtypes. We collected clinical, pathological and prognostic data for analyses.
RESULTS: The median follow-up was 45.5 months. Overall survival (OS) and recurrence-free survival (RFS) were significantly correlated with multifocal RLPS, pathological subtype, recurrent RLPS and histological grade (P for OS = 0.011, 0.004, 0.010, and < 0.001, P for RFS = 0.004, 0.001, < 0.001, and < 0.001, respectively). The 5-Year Estimate OS of well-differentiated liposarcoma (WDLPS), G1 RLPS, de novo RLPS and unifocal RLPS were 100%, 89.4%, 75.3% and 69.1%, respectively. The distant metastasis rate was 1.4%. The morbidity rates (≥ grade III) for suprapancreatic, pancreatic, and subpancreatic RLPS were 26.7%, 15.6%, and 13.3%, respectively. The perioperative mortality rate is 2.6%.
CONCLUSIONS: Standardized aggressive surgical policies demonstrated prognostic benefits for RLPS, particularly for G1 RLPS, WDLPS, unifocal RLPS, and de novo RLPS. This approach effectively balanced considerations of adequate exposure, surgical safety, and thorough removal of all fat tissue. G1 RLPS, WDLPS, unifocal RLPS, and de novo RLPS could be potential indications for aggressive surgical policies.
METHODS: We recruited 77 patients with RLPS who underwent aggressive surgical policies. Patients were categorized into three surgical subtypes: suprapancreatic RLPS, pancreatic RLPS, and subpancreatic RLPS. Our standardized surgical strategy involved resecting macroscopically uninvolved adjacent organs according to surgical subtypes. We collected clinical, pathological and prognostic data for analyses.
RESULTS: The median follow-up was 45.5 months. Overall survival (OS) and recurrence-free survival (RFS) were significantly correlated with multifocal RLPS, pathological subtype, recurrent RLPS and histological grade (P for OS = 0.011, 0.004, 0.010, and < 0.001, P for RFS = 0.004, 0.001, < 0.001, and < 0.001, respectively). The 5-Year Estimate OS of well-differentiated liposarcoma (WDLPS), G1 RLPS, de novo RLPS and unifocal RLPS were 100%, 89.4%, 75.3% and 69.1%, respectively. The distant metastasis rate was 1.4%. The morbidity rates (≥ grade III) for suprapancreatic, pancreatic, and subpancreatic RLPS were 26.7%, 15.6%, and 13.3%, respectively. The perioperative mortality rate is 2.6%.
CONCLUSIONS: Standardized aggressive surgical policies demonstrated prognostic benefits for RLPS, particularly for G1 RLPS, WDLPS, unifocal RLPS, and de novo RLPS. This approach effectively balanced considerations of adequate exposure, surgical safety, and thorough removal of all fat tissue. G1 RLPS, WDLPS, unifocal RLPS, and de novo RLPS could be potential indications for aggressive surgical policies.
摘要：
背景：腹膜后脂肪肉瘤（RLPS）占腹膜后肉瘤的大多数。虽然手术切除仍然是唯一的治疗方法，确定RLPS的最佳手术策略仍然难以捉摸.这项研究解决了围绕RLPS最佳手术策略的持续辩论。
方法：我们招募了77例接受积极手术治疗的RLPS患者。患者分为三种手术亚型：胰腺上RLPS，胰腺RLPS,和胰腺下RLPS。我们的标准化手术策略涉及根据手术亚型切除宏观上未受累的相邻器官。我们收集了临床，用于分析的病理和预后数据。
结果：中位随访时间为45.5个月。总生存期（OS）和无复发生存期（RFS）与多灶性RLPS显著相关，病理亚型,复发RLPS和组织学分级(OS分别为P=0.011,0.004,0.010和<0.001,RFS分别为P=0.004,0.001,<0.001和<0.001)。高分化脂肪肉瘤（WDLPS）的5年估计OS，G1RLPS，从头RLPS和单焦点RLPS为100%，89.4%,75.3%和69.1%，分别。远处转移率为1.4%。胰腺上的发病率（≥III级），胰腺,胰下RLPS为26.7%，15.6%,和13.3%，分别。围手术期死亡率为2.6%。
结论：标准化的积极手术策略证明了RLPS的预后益处，特别是对于G1RLPS，WDLPS,单焦点RLPS，和从头RLPS。这种方法有效地平衡了充分暴露的考虑，手术安全,彻底去除所有脂肪组织。G1RLPS，WDLPS,单焦点RLPS，从头RLPS可能是积极手术政策的潜在指征。
方法：我们招募了77例接受积极手术治疗的RLPS患者。患者分为三种手术亚型：胰腺上RLPS，胰腺RLPS,和胰腺下RLPS。我们的标准化手术策略涉及根据手术亚型切除宏观上未受累的相邻器官。我们收集了临床，用于分析的病理和预后数据。
结果：中位随访时间为45.5个月。总生存期（OS）和无复发生存期（RFS）与多灶性RLPS显著相关，病理亚型,复发RLPS和组织学分级(OS分别为P=0.011,0.004,0.010和<0.001,RFS分别为P=0.004,0.001,<0.001和<0.001)。高分化脂肪肉瘤（WDLPS）的5年估计OS，G1RLPS，从头RLPS和单焦点RLPS为100%，89.4%,75.3%和69.1%，分别。远处转移率为1.4%。胰腺上的发病率（≥III级），胰腺,胰下RLPS为26.7%，15.6%,和13.3%，分别。围手术期死亡率为2.6%。
结论：标准化的积极手术策略证明了RLPS的预后益处，特别是对于G1RLPS，WDLPS,单焦点RLPS，和从头RLPS。这种方法有效地平衡了充分暴露的考虑，手术安全,彻底去除所有脂肪组织。G1RLPS，WDLPS,单焦点RLPS，从头RLPS可能是积极手术政策的潜在指征。
