The Clinical Diagnosis And Survival Analysis Of 45 Cases Of Primary Retroperitoneal Liposarcoma

Objective Primary retroperitoneal liposarcoma(PRLS)is a rare malignant tumor often without specific symptoms in early stage.In order to improve the level of diagnosis and treatment,we summarized the clinical features,diagnosis and treatment of retroperitoneal liposarcoma,and also analyzed the risk factors affecting prognosis.Method We collected the clinicopathological data and follow-up data of 45 PRLS patients who accepted surgical resection between January 2008 and June 2018 at Shengjing Hospital of China Medical University.And then summarized and discussed this disease according to relevant literature.The data were statistically analyzed using SPSS 20.0 software.Kaplan-Meier survival curves were drawn to calculate the overall survival(OS),the differences between the survival curves and the Single-factor analysis were tested by the Log-rank test.Then the cox multivariate regression model was used to analyze the independent risk factors of patients' prognosis.P<0.05 was considered to be statistically signification.Result The clinical manifestations of 45 PRLS patients were as following: 14 cases(31.11%)in abdominal mass,16 cases(35.56%)in abdominal distension,10 cases(22.22%)in abdominal pain,4 cases(8.89%)in physical examination and 1 case(2.22%)was changed in bowel habits.CT is currently the most common imaging examination method.The patients were divided into initial group(35 cases)and recurrence group(10 cases)according to whether the patients were incipient or not.All patients underwent surgical treatment,42 patients with radical resection and 3 patients with palliative resection because of heavy adhesion.There were 32 cases of recurrence(71.11%)after operation,consist of 22 cases in initial group(recurrence rate 62.86%)and 10 cases in recurrence group(recurrence rate 100%)(P<0.05).The mainly postoperative pathological type was differentiated liposarcoma(29 cases,64.44%).The 5-year OS of all 45 PRLS patients was 49.0%.The OS at 1 year,3 years,and 5 years was 74.3%,67.3%,and 52.7%,respectively in primary group,and 66.7%,44.4% and 11.1%,respectively in recurrent group(?2=4.11,P<0.005).Univariate analysis showed that whether the tumor was firstly diagnosed,whether there was recurrence,whether radical resection,number of the tumors and pathological type were important factors in the survival time of patients(both P<0.05).Multivariate analysis of Cox regression model showed that the tumor pathological type was an independent prognosis factors(RR=1.67(1.23-2.56),P<0.05).Conclusion Retroperitoneal liposarcoma is a rare disease with high recurrence and it is difficult to diagnose due to its special location and non-specific clinical manifestations.The main treating method is surgical procedures.Whether the tumor is first diagnosed,whether there is recurrence,whether radical resection,number of tumor and pathological type are important factors that affect patients' survival.And pathological type is an independent prognostic factor.