背景:短期(≤1年)复发(STR)是影响腹膜后脂肪肉瘤(RPLS)手术切除患者生活质量和生存时间的主要决定因素,发病机制复杂而模糊的状况。目的分析RPLS和原发性腹膜后脂肪肉瘤(PRPLS)病例与STR相关的危险因素。
方法:对于这项回顾性观察研究,共选择296例RPLS作为研究对象,在随访期间出现肿瘤复发。使用Kaplan-Meier方法估计局部无复发生存率(LRFS),随后使用对数秩检验进行组间比较。随后的分析涉及单变量和多变量逻辑回归,以确定RPLS病例中STR的预测因子。此外,建立PRPLS的逻辑回归模型.
结果:1-,3-,296例RPLS的5年LRFS率为51.7%,16.9%,和7.1%,分别。在单变量分析中,发现几个因素与STR有关,包括术前中性粒细胞/淋巴细胞比率(NLR),吸烟史,手术频率,联合器官切除,手术时间,术中出血,转移到重症监护病房(ICU),多原发肿瘤,肿瘤形状和包膜特征,组织学亚型,和肿瘤坏死的存在。术前NLR升高,手术频率≥3次,转移到ICU,多原发肿瘤的存在,肿瘤坏死被确定为手术切除的RPLS中STR的独立危险因素。相反,糖尿病,完整的肿瘤包膜,分化良好的组织学亚型似乎是独立的保护因素。PRPLS分析表明,肿瘤包膜和肿瘤坏死是STR的独立预测因素。
结论:术前NLR升高,手术频率≥3次,转移到ICU,多原发肿瘤的存在,肿瘤坏死,和肿瘤包膜有望作为STR手术切除的RPLS和PRPLS的预测因素。
BACKGROUND: The short-term (≤ 1 year) recurrence (STR) is the primary determinant impacting both the life quality and survival duration in patients who have undergone surgical resection for retroperitoneal liposarcoma (RPLS), a condition with intricate and ambiguous pathogenesis. The purpose of this study was to analyze the risk factors associated with STR in cases of RPLS and primary retroperitoneal liposarcoma (PRPLS).
METHODS: For this retrospective observational study, a total of 296 RPLS cases were selected as research subjects, who experienced tumor recurrence during the follow-up period. The Local recurrence-free survival (LRFS) rates were estimated using the Kaplan-Meier method and subsequently compared between groups utilizing the log-rank test. The subsequent analyses involved univariate and multivariate logistic regression to identify predictors of STR in RPLS cases. Additionally, a logistic regression model was constructed for PRPLS.
RESULTS: The 1-, 3-, and 5-year LRFS rates of the 296 RPLS cases were 51.7%, 16.9%, and 7.1%, respectively. In the univariate analysis, several factors were found to be associated with STR, including preoperative neutrophil/lymphocyte ratio (NLR), smoking history, surgical frequency, combined organ excision, operative time, intraoperative bleeding, transfer to the intensive care unit (ICU), multiple primary tumors, tumor shape and capsule characteristics, histological subtype, and presence of tumor necrosis. The elevated preoperative NLR, surgical frequency of ≥ 3 times, transfer to the ICU, presence of multiple primary tumors, and tumor necrosis were identified as independent risk factors for STR in surgically resected RPLS. Conversely, diabetes, intact tumor capsule, and well-differentiated histological subtype appeared to be independent protective factors. Analysis for PRPLS revealed that tumor capsule and tumor necrosis were independent predictors of STR.
CONCLUSIONS: The elevated preoperative NLR, surgical frequency of ≥ 3 times, transfer to the ICU, presence of multiple primary tumors, tumor necrosis, and tumor capsule were expected to serve as predictive factors of STR for surgical resected RPLS and PRPLS.