Avtor/Urednik		Eržen, Darja; Novak, Janez; Senčar, Mojca
Naslov		Kirurgija sarkomov retroperitoneja
Prevedeni naslov		Surgical treatment of the retroperitoneal sarcoma
Tip		članek
Vir		Zdrav Vestn
Vol. in št.		Letnik 72, št. Suppl 1
Leto izdaje		2003
Obseg		str. I-53-5
Jezik		slo
Abstrakt		Background. Retroperitoneal sarcomas are malignant tumors with an aggressive course of disease. Cause of death is local disease in 50% and disseminated disease in only 25%. We made a retrospective analysis of surgical treatment of retroperitoneal sarcomas in order assess the effect of this treatment modality on the course of the disease. In the years between 1975 and 2000, 155 patients were surgically treated for primary retroperotneal sarcoma at the Institute of Oncology in Ijubljana. Only 81 of 155 patients received the first treatment at our Institute, while other patients had been at least once operated on elsewhere before the admission to our Institute. Of these patients, 40 required a second surgery for the residual disease and 31 for recurrence. In 23 patients, metastatic spread was found at diagnosis. Our treatment approach was aggressive. We surgically removed the recurrent sarcomas and metastases wherever accessible. Operability at the first surgical treatment performed at the Institute of Oncology was 92%. Therefore, 44 patients underwent 3 or more surgeries for sarcoma. The highest number of operations performed in one patients was 9 (2 patients). In 227 patients, the tumor block resection involved at least one additional organ (up to 6). Results. Complications were not sparse; perioperative mortality was 8.4%. The survival depended upon the metastatic spread at diagnosis, tumor grade and oncologic surgery type. Conclusions. Despite complications, only complete resection without microscopic resuduum and contamination yields a long-term survival to the patients with retroperitoneal sarcoma.
Izvleček		Izhodišča. Retroperitonealni sarkomi so bolezen z agresivnim potekom, vzrok smrti je samo lokalna bolezen v 50%, samo razsejana pa le v 25%. Da bi ugotovili, kako kirurško zdravljenje vpliva na potek bolezni, smo opravili retrospektivno analizo. 155 bolnikov s primarnimi retroperitonealnimi sarkomi je bilo operiranih na Onkološkem inštitutu v Ljubljani v letih 1975 do 2000. Le 81 bolnikov je bilo operiranih pri nas prvič preostali so bili prej vsaj enkrat operirani drugje. Od teh je bilo 40 bolnikov operiranih zaradi ostanka bolezni (rezidualni), 31 bolnikov pa že zaradi ponovitve bolezni (recidivni sarkomi). Pri 23 bolnikih je bila bolezen razsejana že ob diagnozi. Naš pristop k bolezni je bil agresiven, operirali smo recidive in metastaze, če je bilo le mogoče. Operabilnost pri prvi operaciji pri nas je bila 92%. 44 bolnikov je bilo tako operiranih tri- ali večkrat; največje število operacij zaradi sarkoma pri enem bolniku je bilo 9 (2 bolnika). Pri 127 bolnikih je bil v bloku s tumorjem reseciran vsajš{e en organ (do 0). Rezultati. Zapletov je bilo veliko, perioperativna smrtnost je bila 8,4%. Preživetje je bilo odvisno od onkološkega tipa kirurgije, zasevkov ob diagnozi in stopnji malignosti tumorja. Zaključki. Le kompletna odstranitev tumorja brez mikroskopskega ostanka in kontaminacije kljub zapletom omogoča bolnikom z retroperitonealnimi sarkomi dolgotrajno preživetje.
Deskriptorji		RETROPERITONEAL NEOPLASMS SARCOMA SURVIVAL ANALYSIS