拉丁美洲原发性腹膜后肉瘤治愈性治疗后的治疗方法、结果和复发模式的差异:拉丁美洲腹膜后肉瘤协作工作组关于 333 名患者的报告

Dorian Yarih García-Ortega , Sergio Damian Quildrian , Nicolas A. Devaud , Catherine Sarre-Lazcano , Diana Otero Norza , Paul Adriazola Vicente
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摘要

背景和目的腹膜后肉瘤(RPS)是一种罕见肿瘤,有几种明确的组织学亚型。这项研究旨在评估拉丁美洲腹膜后肉瘤患者的流行病学、治疗模式和预后,并分析在参考中心接受治疗的大量患者的复发模式和治疗差异。方法这项回顾性描述性研究利用了 LATAMSARC(一个研究肉瘤的团体,由拉丁美洲多个国家的不同中心组成,包括阿根廷、智利、哥斯达黎加、墨西哥和秘鲁)的电子病历数据库。研究对象包括在拉丁美洲六个癌症中心接受手术的腹膜后肉瘤成年患者(≥18 岁)。结果在这项回顾性研究中,333 名确诊为腹膜后肉瘤的患者符合纳入/排除标准。其中女性157人(42.3%),男性176人(57.7%),平均年龄53.9岁(标清13.37岁)。组织学上最常见的肿瘤包括低分化脂肪肉瘤(31.5%)、高分化脂肪肉瘤(29.7%)和雷米肉瘤(9.9%)。肿瘤主要位于腹膜后(81.7%),平均直径为 23.53 厘米(标清 13.8 厘米)。手术干预方式各不相同,31.2%的病例进行了完全腔室切除术,29.4%的病例进行了简单完全切除术。术后并发症记录在案,16.8%的患者出现了克拉维恩-丁度(Clavien-Dindo)≥3级并发症。91.6%的病例获得了R0/1切除。术后入住重症监护室的比例为18.6%。8.1%的患者接受了放疗等辅助治疗。20.7%的病例出现局部复发,其中大多数为同侧复发。15例患者出现远端复发,主要累及肝脏。平均总生存期为 65.5 个月,无病生存期为 47.0 个月。 结论:这项研究提供了拉丁美洲一组参考中心腹膜后肉瘤的流行病学、治疗模式和结果。这些结果是拉丁美洲关于腹膜后肉瘤的最大证据库。
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Variability in treatment approaches, outcomes, and recurrence patterns after curative intent treatment for primary retroperitoneal sarcomas in Latin America: A report on 333 patients from LATAMSARC collaborative working group

Background and objective

Retroperitoneal sarcomas (RPS) are rare tumors with several well-defined histologic subtypes. This study aimed to assess the epidemiology, treatment patterns, and outcomes of patients with retroperitoneal sarcoma in Latin America and analyze patterns of recurrence and treatment variations in a large population of patients treated at reference centers.

Methods

This retrospective descriptive study utilized an electronic database of medical records from LATAMSARC (a group studying sarcomas consisting of different centers in various countries in Latin America, including Argentina, Chile, Costa Rica, Mexico, and Peru). Adult patients (≥18 years) with retroperitoneal sarcoma who underwent surgery at six cancer centers in Latin America were included. Key outcomes were practice patterns, overall survival (OS), and progression-free survival (PFS).

Results

In this retrospective study, 333 patients diagnosed with retroperitoneal sarcomas met the inclusion/exclusion criteria. The cohort consisted of 157 females (42.3 %) and 176 males (57.7 %), with an average age of 53.9 years (SD 13.37). Histology most commonly included Dedifferentiated Liposarcoma (31.5 %), Well-Differentiated Liposarcoma (29.7 %), and Leiomyosarcoma (9.9 %). The tumors predominantly resided in the retroperitoneum (81.7 %) and showed a mean diameter of 23.53 cm (SD 13.8 cm). Surgical interventions varied, with Complete Compartmental Resection performed in 31.2 % of cases and Simple Complete Resection in 29.4 %. Postoperative complications were documented, with Clavien-Dindo Grade ≥3 complications occurring in 16.8 % of patients. An R0/1 resection was obtained in 91.6 % of cases. The ICU admission rate post-surgery was 18.6 %. Adjuvant treatments included radiotherapy in 8.1 %. Local recurrence occurred in 20.7 % of cases, with the majority being ipsilateral. Distal recurrence was observed in 15 patients, predominantly affecting the liver. The mean overall survival was 65.5 months, and disease-free survival was 47.0 months.

Conclusion

This study provides information on the epidemiology, treatment patterns, and outcomes of retroperitoneal sarcomas in a group of reference centers in Latin America. These results represent Latin America's largest body of evidence on retroperitoneal sarcomas.
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