腹膜后平滑肌肉瘤手术治疗的预后因素：一项回顾性多中心研究。

IF 2.7 3区医学 Q1 SURGERY

American journal of surgery Pub Date : 2025-09-30 DOI:10.1016/j.amjsurg.2025.116647

Xiaole Lu , Aobo Zhuang , Yancheng Lai , Likai Ren , Yanan Gao , Bin Yang , Na Ta , Rui Zhou , Longxin Deng , Haoqing Shi , Han Wu , Qianwen Zhang , Xin Cheng , Lijie Ma , Xiaofeng Wu , Ting Shi , Shenfan Wang , Chen Lv , Yong Zhang , Xiang Feng , Rui Chen

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引用次数: 0

摘要

背景：腹膜后平滑肌肉瘤（RLMS）的罕见性和孤立病例报告的普遍性阻碍了预后预测。本研究旨在确定原发性RLMS初始切除和随后复发手术后总生存（OS）的预后因素，特别强调复发情况，这是一个不太明确的特征。方法：我们分析了2002年1月至2022年12月来自两个中心的227例RLMS患者。Cox比例风险模型确定了自变量。结果：原发性RLMS的中位随访时间为42个月（IQR 21-95个月），复发性RLMS的中位随访时间为40个月（IQR 24-73个月），整个队列的中位随访时间为43个月（IQR 21-83个月）。在最后一次随访中，原发组78例（61.4%）和复发组33例（33%）被剔除。原发患者中位OS为62个月，复发患者中位OS为33个月。OS的独立危险因素包括：原发性RLMS的最大肿瘤直径、FNCLCC （f ）分级、血小板计数（PLT）和中性粒细胞/淋巴细胞比率（NLR），而复发性RLMS的NLR和无病间期具有重要意义。结论：术后复发性RLMS患者的长期生存是可以实现的，NLR和无病间隔是这种情况下的关键预后因素。这些发现可能有助于风险分层和治疗决策。

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The prognosis factors landscape of surgical management of retroperitoneal leiomyosarcoma: A retrospective multicenter study

Background

The rarity of retroperitoneal leiomyosarcoma (RLMS) and the prevalence of isolated case reports hinder outcome predictions. This study aimed to identify prognostic factors for overall survival (OS) after initial resection of primary RLMS and subsequent surgery for recurrence, with a particular emphasis on the recurrent setting which is less well-characterized.

Methods

We analyzed 227 RLMS patients who underwent surgery from January 2002 to December 2022 from two centres. Cox proportional hazard models identified independent variables.

Results

The median follow-up was 42 months (IQR 21–95 months) for primary RLMS, 40 months (IQR 24–73 months) for recurrent RLMS and 43 months (IQR 21–83 months) for overall cohort. At the last follow-up, 78 patients (61.4 %) in the primary group and 33 patients (33 %) in the recurrent group were censored. Median OS was 62 months for primary and 33 months for recurrent cases. Independent risk factors for OS included maximum tumor diameter, FNCLCC (Fédération Nationale des Centres de Lutte Contre le Cancer) grade, platelet count (PLT), and neutrophil/lymphocyte ratio (NLR) for primary RLMS, while NLR and disease-free interval were significant for recurrent RLMS.

Conclusions

Long-term survival is achievable in selected recurrent RLMS patients post-surgery, with NLR and disease-free interval being critical prognostic factors in this setting. These findings may aid in risk stratification and treatment decisions.

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来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.