| Objective To explore the influencing factors of postoperative survival and progression free survival of primary retroperitoneal sarcoma and analyze its biological characteristics.Methods From January 1,2012 to December 1,2017,the clinicopathological data and follow-up data of patients diagnosed as primary retroperitoneal sarcoma in our hospital were collected,including 55 cases of primary retroperitoneal liposarcoma and 20 cases of primary leiomyosarcoma.To evaluate the impact of various factors on the survival and progression free survival of patients with retroperitoneal sarcoma.The survival curve was compared by Kaplan Meier method,and the log rank was used to get the numerical evaluation whether it was significant for survival and progression free survival.Cox proportional risk model was used to analyze the variables with P < 0.05 in univariate analysis.Results The tumor diameter of 75 patients with primary retroperitoneal sarcoma was 12(7-33),36 males(48%),39 females(52%),body mass index(24.1 ± 3.4).The average age that patients were diagnosed was 58 years old.Of all the patients,76 years old was the oldest and 36 years old was the youngest.There were 15 cases(20%)of sarcomas with major vascular adhesion,39 cases(52%)of sarcomas in the left position and 36 cases(48%)in the right position.The operation time of retroperitoneal sarcoma was245(180-300)min,the postoperative hospital stay was 11(9-18)days,and the intraoperative bleeding volume was 550(100-1500)ml.Among the 75 patients,45 were completed the complete resection,at least one adjacent organ was removed in 48 patients,and three or more adjacent organs were removed in 20 patients.The 1,3,5-year survival rate was 89.7%,72.4%,55.2% and the total survival rate was 50%.The result was that age(X~2= 0.048,P = 0.827),gender(X~2=0.113,P = 0.737),preoperative albumin(X~2 =0.195,P = 0.443),invasion of adjacent organs(X~2 =0.881,P = 0.348),tumor diameter(X~2=0.063,P = 0.802)had no effect on the survival of retroperitoneal sarcoma,while surgical resection(X~2=9.783,p=0.002),histological type(X~2=27.127,p=0.000),tumor grade(X~2=22.874,p=0.000),multifocality(X~2=6.293,p=0.012)had an effect on prognosis.Multifocality was related to the survival time of retroperitoneal sarcoma,which was analyzed by multiple factors(X~2=0.063,P = 0.801).Histological types could affect the prognosis of retroperitoneal sarcoma(HR=3.24,95%CI 1.45-7.24,p=0.004).In addition,surgical resection (HR=4.58,95%CI 1.5-13.77,p=0.007),tumor grade(HR=2.73,95%CI 1.06-7.05,p=0.038)were also important prognostic factors.The results of univariate analysis for predicting recurrence free progression of retroperitoneal sarcoma were as follows: age(X~2= 0.222,P = 0.638),multifocality(X~2= 0.791,P = 0.374),gender(X~2 = 0.313,P = 0.576),preoperative albumin(X~2= 0.132,P = 0.716),invasion of adjacent organs(X~2 = 0.814,P = 0.367),tumor diameter(X~2=0.076,p=0.783).These factors had no effect on the survival of retroperitoneal sarcoma.Surgical resection(X~2=5.277,P = 0.001),histological type(X~2= 7.507,P = 0.006),tumor grade(X~2= 9.593,P = 0.002)were important predictors.In multivariate analysis,tumor grade was not an independent risk predictor(X~2= 2.21,P = 0.137),while surgical resection(HR = 3.24,95% CI 1.55-6.79,P = 0.002)and histologic type(HR = 2.24,95% CI 1.18-5.06,P = 0.016)were independent predictors of retroperitoneal sarcoma progression.Conclusion The diagnosis of retroperitoneal sarcoma was older(average age 58 years),but it could occur in any age group,and there was no difference in gender distribution.Tumor grade,radical resection and histological type could affect survival.Radical resection and histological type could change progression free survival of retroperitoneal sarcoma. |
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