| Objective:To investigate the perioperative factors in patients with retroperitoneal paraganglioma and to explore the factors that may affect the prognosis of patients with retroperitoneal paraganglioma.Materials and Methods:The clinical and pathological data of 100 patients with retroperitoneal paraganglioma who underwent surgery in the Affiliated Hospital of Qingdao University from July 2001 to December 2018 were retrospectively analyzed.All cases were confirmed by pathological examination.Collect general information,auxiliary examination results,surgical related factors,and tumor related factors.The patients were followed up.The follow-up was performed by outpatient and telephone.The follow-up date was as of February 28,2019.The follow-up content mainly included postoperative survival and recurrence of patients with retroperitoneal paraganglioma.Of the 100 patients,54(54%)were male and 46(46%)were female;the age ranged from 23 to 78 years,with a median age of 50 years;59 patients with symptoms,including 40 with hypertension,no There were 41 cases of symptoms.There were 87 patients in the open surgery group and 13 patients in the minimally invasive surgery group.The operation time was 50-520 min,the median operation time was 180 min,the intraoperative blood loss was 10-5000 ml,the median blood loss was 100 ml,and the intraoperative blood transfusion was 15 patients,there were 85 patients without intraoperative blood transfusion;98 patients underwent complete tumor resection,2 patients underwent palliative resection of the tumor;32 patients had intraoperative hypertension,68 patients did not have intraoperative hypertension;7 patients had postoperative Adjuvant chemoradiation was performed in 93 patients who underwent postoperative radiotherapy and chemotherapy.The tumor diameter was 1-19 cm,and the median tumor was 6 cm in diameter.The number of tumors in all patients was single.In terms of tumor texture,72 cases were solid tumors,28 cases were cystic solid tumors,and 91 cases had tumor masses.Membrane,9 cases without tumor capsule;16 cases with tumor necrosis,84 cases without tumor necrosis;60 cases with tumor Ki-67 index<3%,40 cases with≥3%;75 cases with high tumor differentiation,low tumor There were 25 cases of differentiation;27 cases of local invasion of tumor,73 cases of no local invasion of tumor;10 cases of local metastasis of tumor,90 cases of local metastasis without tumor.As of the follow-up date,19 patients(19%)had tumor recurrence and 15(15%)had tumor-related deaths.All relevant factors were analyzed and these factors that may affect the prognosis of patients with retroperitoneal paraganglioma were statistically analyzed.Results:As of the date of follow-up,the overall survival rate of all patients was 70.4%,including 1 year overall survival rate of 97.9%,and 3-year overall survival rate.89.0%,5-year overall survival rate of 80.2%.Univariate analysis showed no symptoms(Log-Rank test:x2=4.294,P=0.038),complete tumor resection(Log-Rank test:x2=24.523,P=0.000),presence or absence of envelope(Log-Rank test:x2=23.512,P=0.000),with or without tumor necrosis(Log-Rank test:x2=9.036,P=0.003),Ki-67 index(Log-Rank test:x2=16.031,P=0.000),tumor grade(Log-Rank test:x2=20.763,P=0.000),with or without local invasion(Log-Rank test:x2=8.434,P=0.004),with or without local transfer(Log-Rank test:x2=7.632,P=0.006)was an important factor in the overall survival of patients with retroperitoneal paraganglioma;multivariate analysis showed tumor Ki-67 index(P=0.017,RR=15.093,95%Cl 1.613-141.239),whether there was local invasion of the tumor(P=0.017,RR=4.848,95%CI 1.333-17.637)were independent risk factors for the overall survival of patients with retroperitoneal paraganglioma.As of the follow-up date,the tumor-free survival rate of all patients with retroperitoneal paraganglioma was 62.3%,including 1-year disease-free survival rate of 96.4%,3-year disease-free survival rate of 86.2%,and 5-year disease-free survival rate of 74.1%.Univariate analysis showed tumor diameter(Log-Rank test:x2=5.314,P=0.021),with or without capsule(Log-Rank test:x2=12.404,P=0.000),with or without tumor necrosis(Log-Rank test:x2=9.036,P=0.003),Ki-67 index(Log-Rank test:x2=10.60,P=0.001),tumor differentiation(Log-Rank test:x2=20.230,P=0.000)The presence or absence of local metastasis(Log-Rank test:x2=7.261,P=0.007)was an important factor in the absence of tumor survival in patients with retroperitoneal paraganglioma;multivariate analysis showed tumor Ki-67 index(P=0.008,RR=6.079,95%CI 1.598-23.121),tumor grade(P=0.009,RR=5.372,95%Cl 1.535-18.796),tumor diameter(P=0.044,RR=3.522,95%CI 1.037-11.956)were independent risk factors for tumor-free survival in patients with retroperitoneal paraganglioma.Conclusion:The 1-year overall survival rate of retroperitoneal paraganglioma is 97.9%,the 3-year overall survival rate is 89.0%,the 5-year overall survival rate is 80.2%;the 1-year tumor-free survival rate is 96.4%,and the 3-year tumor-free survival rate is 86.2%,5-year tumor-free survival rate is 74.1%.Tumor Ki-67 index and local tumor invasion are independent risk factors for the overall survival of patients with retroperitoneal paraganglioma.Tumor Ki-67 index,tumor grade,and tumor diameter are independent risk factors for tumor-free survival in patients with retroperitoneal paraganglioma.Tumor Ki-67 index is an important factor affecting the prognosis of patients with retroperitoneal paraganglioma. |
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