原发性腹膜后副神经节瘤临床诊疗分析

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目的:探讨原发性腹膜后副神经节瘤的手术治疗效果,复发及死亡的影响因素。方法:回顾性分析1985年1月至2015年1月30年间于我院治疗的91例原发性腹膜后副神经节瘤的手术患者的临床资料,统计学方法分析腹原发性腹膜后副神经节瘤手术的治疗效果,预后及复发和死亡的相关因素。结果:77例原发性腹膜后良性副神经节瘤患者,l、3、5年总生存率均为98.5%,复发率分别为2%,4.5%,16%。手术根治度与复发相关(X~2=10.368,P=0.01),手术未完整切除复发率高。性别、年龄、肿瘤部位、肿瘤直径与复发无关(P>0.05)。14例原发性腹膜后恶性副神经节瘤患者,1、3、5年总生存率分别为78.5%、50%,41.5%。14例恶性副神经节瘤复发率分别为71%,85%,100%。肿瘤级别与腹膜后恶性副神经节瘤预后(X~2=5.536,P=0.019)和复发相关(X~2=5.734,P=0.017),肿瘤级别低,死亡率高,复发率高;远处转移与复发相关(X~2=4.067,P=0.044),远处转移患者复发率高;性别、年龄、肿瘤部位、肿瘤直径、手术根治度与预后及复发无关(P>0.05)。结论:良性腹膜后副神经节瘤患者预后较好,手术根治度与复发相关,根治性手术是其主要治疗方式;恶性副神经节瘤预后差,肿瘤分级与其复发及死亡相关,肿瘤分级低复发及死亡率高,远处转移与复发相关,远处转移患者复发率高。 Objective: To investigate the surgical treatment of primary retroperitoneal ganglioma, the impact of recurrence and death factors. Methods: The clinical data of 91 patients with primary retroperitoneal ganglioneuroma treated in our hospital from January 1985 to January 2015 were retrospectively analyzed. Statistical analysis was performed to analyze the effect of abdominal retroperitoneal Therapeutic effect of ganglioma surgery, prognosis and related factors of recurrence and death. Results: The overall survival rate at 1, 3 and 5 years was 98.5% in 77 patients with primary retroperitoneal PMG. The recurrence rates were 2%, 4.5% and 16% respectively. The degree of cure was related to recurrence (X ~ 2 = 10.368, P = 0.01). The incomplete resection had a high recurrence rate. Sex, age, tumor location and tumor diameter had no relation with recurrence (P> 0.05). In 14 patients with primary retroperitoneal malignant paraganglioma, the overall survival rates at 1, 3 and 5 years were 78.5%, 50% and 41.5%, respectively. The recurrence rates of 14 cases of malignant paragangliomas were 71%, 85% and 100% respectively. The grade of tumor was related to the prognosis of retroperitoneal malignant paraganglioma (X ~ 2 = 5.536, P = 0.019) and relapse (X ~ 2 = 5.734, P = 0.017). The tumor grade was low, the mortality was high and the recurrence rate was far. Metastasis was associated with recurrence (X ~ 2 = 4.067, P = 0.044). The recurrence rate was higher in patients with distant metastasis. There was no correlation between gender, age, tumor location, tumor diameter, radical surgery and prognosis and recurrence (P> 0.05). Conclusions: The prognosis of patients with benign retroperitoneal ganglioma is good, and the radical operation is related to recurrence. Radical surgery is the main treatment. Malignant paragangliomas have poor prognosis, tumor grade is associated with recurrence and death, and the tumor grade is low recurrence And high mortality, distant metastasis and relapse, distant metastasis recurrence rate.
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