成人原发性腹膜后畸胎瘤诊治及预后分析
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摘要
目的探讨成人原发性腹膜后畸胎瘤的临床特点、治疗方法及预后。方法回顾性分析我院2001年1月—2018年9月收治的50例成年腹膜后畸胎瘤病人的临床资料及治疗、随访结果,并分析影响肿瘤复发的相关因素。结果 50例病人中男10例,女40例;良性病变49例,恶性病变1例。所有病人均行手术治疗,7例病人术后复发。对影响腹膜后畸胎瘤复发的单因素分析结果显示,病人年龄、肿瘤是否残留与术后复发有关(χ~2=5.05,P<0.05,P=0.002);进一步行多因素Logistic回归分析显示,肿瘤是否残留与术后复发显著相关(OR=13.320,95%CI=0.003～0.414,P<0.05)。结论成人腹膜后畸胎瘤良性多见,主要治疗方式为手术治疗,术前应根据肿瘤的位置及大小选择合适的手术入路,力求完整切除肿瘤,避免复发。无论肿瘤是否良恶性,术后均应定期复查,以尽早发现肿瘤复发或恶变情况,并及时治疗。
Objective To investigate the clinical features,treatment methods,and prognosis of primary retroperitoneal teratoma in adults. Methods A retrospective analysis was performed for the clinical data,treatment,and follow-up data of 50 adult patients with retroperitoneal teratoma who were admitted to our hospital from January 2001 to September 2018,and the influencing factors for tumor recurrence were analyzed. Results There were 10 male and 40 female patients,and of all patients,49 had benign lesions and 1 had malignant lesion.All patients underwent surgical treatment and 7 patients experienced recurrence after surgery.The univariate analysis of the influencing factors for the recurrence of retroperitoneal teratoma showed that age and presence or absence of tumor residue were associated with postoperative recurrence(χ~2=5.05,P<0.05,P=0.002),and further multivariate Logistic regression analysis showed that presence or absence of tumor residue was significantly associated with postoperative recurrence(OR=13.320,95%CI=0.003-0.414,P<0.05). Conclusion Retroperitoneal teratoma in adults is often benign.Surgical treatment is the main treatment method,and appropriate surgical approach should be selected according to tumor location and size before surgery,in order to achieve complete resection of tumor and avoid recurrence.No matter whether the tumor is benign or malignant,regular reexamination should be performed after surgery to identify recurrence or malignant transformation of tumor as soon as possible and give timely treatment.
Objective To investigate the clinical features,treatment methods,and prognosis of primary retroperitoneal teratoma in adults. Methods A retrospective analysis was performed for the clinical data,treatment,and follow-up data of 50 adult patients with retroperitoneal teratoma who were admitted to our hospital from January 2001 to September 2018,and the influencing factors for tumor recurrence were analyzed. Results There were 10 male and 40 female patients,and of all patients,49 had benign lesions and 1 had malignant lesion.All patients underwent surgical treatment and 7 patients experienced recurrence after surgery.The univariate analysis of the influencing factors for the recurrence of retroperitoneal teratoma showed that age and presence or absence of tumor residue were associated with postoperative recurrence(χ~2=5.05,P<0.05,P=0.002),and further multivariate Logistic regression analysis showed that presence or absence of tumor residue was significantly associated with postoperative recurrence(OR=13.320,95%CI=0.003-0.414,P<0.05). Conclusion Retroperitoneal teratoma in adults is often benign.Surgical treatment is the main treatment method,and appropriate surgical approach should be selected according to tumor location and size before surgery,in order to achieve complete resection of tumor and avoid recurrence.No matter whether the tumor is benign or malignant,regular reexamination should be performed after surgery to identify recurrence or malignant transformation of tumor as soon as possible and give timely treatment.
引文
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[13]高峰,徐明,宋枫,等.手术治疗成人骶尾前囊性畸胎瘤16例[J].中华普通外科杂志,2013,28(8):576-578.
[14]张平,孟伟,徐越超,等.经骶尾部切除治疗成人骶前畸胎瘤24例临床分析[J].中国实用外科杂志,2005,25(12):752-753.
[15]孙怀玉,王凤云,李明.超声联合肿瘤标志物对卵巢未成熟畸胎瘤的诊断分析[J].中国现代医学杂志,2018,28:122-124.
[16]FUKUI N,KOHNO Y,ISHIOKA J,et al.Treatment outcome of patients with extragonadalnonseminomatous germ cell tumors:The saitamacancer center experience[J].Int J Clin Oncol,2013,18:731-734.
[2]BHATTI A,AL-HINDI H,AZZAM A,et al.Mature(benign)cystic retroperitoneal teratoma involving the left adrenal gland in a 22-year-old male:A case report and literature review[J].Case Rep Oncol Med,2013,2013:610280.
[3]TIU A,SOVANI V,KHAN N,et al.Primary retroperitoneal mature cystic teratoma(dermoid cyst)in a 51-year-old male:Case report and historical literature review[J].SAGE Open Med Case Rep,2017,5:2050313X17700745.
[4]惠延平,马世荣,程虹,等.性腺外畸胎瘤172例临床病理分析[J].诊断病理学杂志,2006,13(1):17-20,83.
[5]樊继全,周红霞,刘辛秀,等.性腺外生殖细胞肿瘤的诊治现状和进展[J].现代肿瘤医学,2018,26:2138-2141.
[6]GATCOMBE H G,ASSIKISV,KOOBY D,et al.Primary retroperitoneal teratomas:A review of the literature[J].JSurg Oncol,2004,86(2):107-113.
[7]刘小雷,王宇翔,华杰,等.腹膜后双侧巨大畸胎瘤伴恶性变一例[J].中华普通外科杂志,2017,32(10):842.
[8]郭俊超,阎长青,赵玉沛.成人原发性腹膜后畸胎瘤诊治16例[J].中国肿瘤临床,2006,33(19):1130-1131.
[9]孙立波,孙永庆,房学东,等.成人骶尾部表皮样囊肿10例手术治疗体会[J].中国现代手术学杂志,2004,8(4):237-238.
[10]闫冬升,刘卫东,刘业六.骶尾部肿瘤手术治疗18例临床分析[J].中国实用外科杂志,2017,37(8):919.
[11]徐惠成,王丹,王延洲,等.腹腔镜骶尾部畸胎瘤切除术的临床应用[J].第三军医大学学报,2010,32(11):1220-1222.
[12]梅世文,罗成华,陈伟达,等.单孔腹腔镜骶前囊性畸胎瘤切除1例[J].中国微创外科杂志,2017,17(3):279-281.
[13]高峰,徐明,宋枫,等.手术治疗成人骶尾前囊性畸胎瘤16例[J].中华普通外科杂志,2013,28(8):576-578.
[14]张平,孟伟,徐越超,等.经骶尾部切除治疗成人骶前畸胎瘤24例临床分析[J].中国实用外科杂志,2005,25(12):752-753.
[15]孙怀玉,王凤云,李明.超声联合肿瘤标志物对卵巢未成熟畸胎瘤的诊断分析[J].中国现代医学杂志,2018,28:122-124.
[16]FUKUI N,KOHNO Y,ISHIOKA J,et al.Treatment outcome of patients with extragonadalnonseminomatous germ cell tumors:The saitamacancer center experience[J].Int J Clin Oncol,2013,18:731-734.