Diagnosis And Treatment Of Prognosis Of Retroperitoneal Liposarcoma And Its Prognostic Factors

Objective To summary the experience of retroperitoneal liposarcoma in diagnosis and management. To analyze prognostic factors associated with retroperitoneal liposarcoma.Methods 61 Patients with retroperitoneal liposarcoma were admitted to department of hepatobiliary surgery, affiliated hospital of Qingdao university and followed between January 1, 2000 and December 30, 2014. Data of patient, tumor and management was analyzed retrospectively.Results Median overall survival of patients with retroperitoneal liposarcoma after surgery was 81 months for the those with primary disease, 47 months for those with local recurrence and 9 months for those with metastasis. The 1 year overall survival for the group of primary disease, local recurrence and metastasis is 95.1%, 87.5%, 25.0% respectively, the 2 years overall survival is 92.3%, 62.5%, 0 respectively, the 5 years overall survival is 71.8%, 31.3%, 0 respectively. There is significant difference in overall survival among above three groups(Log-rank test:χ2=23.127,P<0.001).Univariate analysis showed histological subtype, intraoperative hemorrhage and operation time were the influencing factors to the overall survival after surgery(P<0.05). Multivariate analysis demonstrated status of tumor resection(P=0.038, RR=4.21), histological subtype(P=0.027, RR=3.01)and intraoperative hemorrhage(P=0.035,RR=7.72)were independent risk factors for the overall survival after surgery. The median disease free survival of patients with retroperitoneal liposarcoma after surgery was 36 months. The disease free survival of 1 year, 2 years and 5 years was 90.6%, 69.2% and 24.2% respectively. Univariate analysis showed histological subtype, histologic grade, intraoperative hemorrhage and operation time were the influencing factors for the local recurrence after surgery(P<0.05). Multivariate analysis demonstrated histological subtype(P=0.002,RR=1.85) and diameter of tumor(P=0.043,RR=2.29)were independent risk factors for the local recurrence after surgery. The median metastasis free survival of patients with retroperitoneal liposarcoma after surgery was 84 months. The metastasis free survival of 1 year, 2 years and 5 years was 92.9%, 79.4%, 71.4% respectively. Univariate analysis showed status of tumor resection, histologic grade, age and operation time were the influencing factors for the metastasis after surgery(P<0.05). Multivariate analysis demonstrated histologic grade(P=0.047,RR=2.15)was independent risk factors for the metastasis after surgery.Conclusion There is no specific symptoms in the early stage of retroperitoneal liposarcoma. The status of tumor resection, intraoperative hemorrhage, diameter of tumor histologic grade and histological subtype are the prognostic factors for retroperitoneal liposarcoma. We should pay more attention to the complete resection of the tumor, try our best to improve the rate of complete resection in order to decline the recurrence rate, prolong the recurrence interval. The finial purpose is to improve the life quality of the people with retroperitoneal liposarcoma.