背景:骨盆软组织肉瘤(STS)存在手术和肿瘤挑战。我们调查了接受盆腔肉瘤切除术的患者的预后。
方法:回顾性分析了2014年至2021年在三级学术转诊中心接受STS手术切除的所有患者(n=172)。包括所有起源于或延伸至盆腔的原发性或复发性STS患者(n=29)。
结果:该队列分为原发性盆腔肉瘤(n=18)和复发性盆腔肉瘤(rPS,n=11)。26例患者完成了R0/R1切除(89.6%)。术后并发症发生率为48.3%。主要并发症发生率为27.5%。手术后的中位随访时间为12.3个月(范围,0.6-60.3个月)。原发性盆腔肉瘤组的无病生存率优于rPS组(P=0.002)。然而,总生存率没有显着差异,(P=0.52)。单变量和多变量分析确定rPS组(危险比8.68,P=0.006)和切除边缘(危险比6.29,P=0.004)与无病生存率独立相关。
结论:我们已经证明实现R0/R1切除是可行的。肿瘤结果对原发性肿瘤有利,而复发性肿瘤表现出早期复发。考虑切除复发性骨盆STS应进行仔细的多学科评估。
Soft tissue sarcomas (STS) of the pelvis present a surgical and oncological challenge. We investigated the outcomes of patients undergoing resection of pelvic sarcomas.
A retrospective analysis of all patients who underwent surgical resection for STS between 2014 and 2021 at a tertiary academic referral center (n = 172). Included all patients with primary or recurrent STS which originated or extended to the pelvic cavity (n = 29).
The cohort was divided into primary pelvic sarcomas (n = 18) and recurrent pelvic sarcomas (rPS, n = 11). Complete R0/R1 resection was achieved in 26 patients (89.6%). The postoperative complication rate was 48.3%. The rate of major complications was 27.5%. The median time of follow-up from surgery was 12.3 months (range, 0.6-60.3 months). Disease-free survival was superior in the primary pelvic sarcomas group compared to the rPS group (P = 0.002). However, there was no significant difference in overall survival, (P = 0.52). Univariant and multivariant analyses identified rPS group (Hazard Ratio 8.68, P = 0.006) and resection margins (Hazard Ratio 6.29, P = 0.004) to be independently associated with disease-free survival.
We have demonstrated that achieving R0/R1 resection is feasible. Oncological outcomes are favorable for primary tumors, whereas recurrent tumors exhibit early recurrences. Consideration of resection of recurrent pelvic STS should involve a careful multidisciplinary evaluation.