The Clinical Diagnosis And Prognosis Analysis Of Primary Liposarcoma Retroperitoneal

Objective Primary retroperitoneal liposarcoma(RPLS)is a rare malignant tumor without specific symptoms.In order to improve the clinical diagnosis and treatment of patients with RPLS,we retrospectively analyzed therapeutic modalities,clinicopathological features and the risk factors affecting the survival prognosis of the patients.Methods A total of 39 RPLS patients who underwent surgical resection between January 2006 and December 2016 at Fu Jian Tumor Hospital were analyzed.The clinicopathological data of the patients and follow-up data were reviewed.The data were statistically analyzed using SPSS 22.0 software.Kaplan-Meier survival curves were drawn to calculate the overall survival(OS)of the patients,and the differences between them according to various different factors were tested by the Log-rank test.Kaplan-Meier method was utilized to confirm the univariables of the overall survival rate of patients with PRLS.Then the cox multivariate regression model was used to analyze the independent risk factors of patients' survival.P<0.05 was considered to be statistically significant.Results The main clnical manifestations included,found by physical examination(10.3%),abdominal mass and enlarge radually(61.5%),abdominal pain and distension(48.7%),tumor compression symptoms(17.9%),intratumoral hemorrhage(2.6%).CT was the main imaging examination.The patients were divided into primary group(27 cases)and recurrence group(n = 12).All patients received surgery,including 37 cases of complete resection and 2 case of palliative resection.Totally,there were 28 cases of recurrence after surgery(71.8%),including 16 cases in primary group(recurrence rate,59.3%)and 12 cases recurrence in recurrence group(recurrence rate,100%)(P < 0.05).Postoperative pathology revealed that predominantly the well differentiated liposarcoma was diagnosed(21 cases,53.8%),and then the dedifferentated liposarcoma(14 cases,35.9%).The 5-year OS of all patients with PRLS was 49%.The 1-,3-and 5-years OS for the primary group were 92.4%,84% and 65%,respectively;and 91.7%,23.6%,11.8%,respectively for the recurrence group(X2=10.130,P < 0.001).Univariate analysis showed that the primary onset,R0 resection and the specific pathological subtype were the influencing factors for the patients' OS after surgery(all P < 0.05).Multivariate analysis demonstrated the primary onset(RR= 1.24(2.80-5.57)was the independent risk factors for the patients' survival.(P < 0.05).Conclusions RPLS is difficult to detect and diagnosis at the early stage.PRLS has a high rate of recurrence.R0 resection is the main treatment for PRLS.The primary onset,R0 resection and the specific pathological subtype are the prognostic factors for patients with PRLS.And the primary oneset is an independent risk factor for patients' survival.