在早年腹膜后肉瘤的切除率仅40%,由于近年各种现代外科技术的发展,其切除率已高达96%.作者总结1977～1995年纽约州大学外科治疗90例腹膜后肉瘤的经验.全组男女各半,年龄中位值60岁(23～79岁).39例肿瘤位于盆腔,另51例位于中或上腹膜后区;57例为原发灶,33例为复发灶,以脂肪肉瘤(30例)、平滑肌肉瘤(17例)、恶性纤维组织细胞瘤(11例)和神经性肉瘤(10例)为较多见.主要症状为腹块(25例),其余表现为隐痛.手术完全切除86例,部分切除4例.后者均属局部复发灶.无手术后死亡,在43例病人共发生并发症79次,计伤口感染9次、肠麻痹6次、伤口裂开5例、肺不张5次和静脉输液处脓毒症5次.经随访47个月,57例原发灶中发生局部复发14例,在33例复发灶中又有局部复发13例,总局部复发率为30%.局部切除和广泛切除后的复发率分别为56%和16%(p=0.01),单纯手术和手术加用辅助放疗的局部复发率分别为33%和22%,Ⅰ、Ⅱ和Ⅲ级肿瘤局部复发率分别为28%、50%和22%(p=0.11).随访5年时,原发灶和局部复发灶的复发率分别为50%和62%,随访10年时则分别为60%和68%.5年和10年生存率,第一次术后局部复发者分别为49%和25%,而无局部复发者分别为73%和61%.加用或不加用辅助化疗的总复发率(局部和远处)分别为72%和43%,这是由厂病例选择偏差的结果. In the early years, the resection rate of retroperitoneal sarcoma was only 40%. Due to the development of various modern surgical techniques in recent years, the resection rate has reached 96%. The authors summarize the experience of surgical treatment of 90 cases of retroperitoneal sarcoma in New York State University from 1977 to 1995. Half of the male and female subjects had a median age of 60 years (range, 23 to 79 years). Thirty-nine tumors were located in the pelvic cavity, another 51 were in the middle or upper retroperitoneal region; 57 were primary and 33 were recurrent foci. Sarcoma (30 cases), leiomyosarcoma (17 cases), malignant fibrous histiocytoma (11 cases) and neurogenic sarcoma (10 cases) were more common. The main symptoms were abdominal mass (25 cases). The rest showed hidden pain. Complete resection was performed in 86 cases and partial resection in 4. The latter were local recurrent lesions. No death occurred after surgery. A total of 79 complications occurred in 43 patients, including 9 wound infections, 6 intestinal paralysis, and wound dehiscence. Cases, 5 cases of atelectasis and 5 cases of sepsis at the intravenous infusion site. After follow-up of 47 months, local recurrence occurred in 57 cases in the primary tumor in 14 cases, and local recurrence in 13 cases in 33 cases of recurrent tumors. The recurrence rate was 30%. The recurrence rates after local resection and extensive resection were 56% and 16%, respectively (p=0.01). The local recurrence rate after surgery and surgery plus adjuvant radiotherapy The local recurrence rates of type I, II, and III tumors were 28%, 50%, and 22%, respectively, in 33% and 22% (p = 0.11). The recurrence rate of primary tumors and local recurrences was 5 years after follow-up. At 50% and 62%, the follow-up at 10 years was 60% and 68%. The 5-year and 10-year survival rates were 49% and 25% for the first postoperative local recurrence, and those without local recurrence were For 73% and 61%, the total recurrence rates (local and distant) with or without adjuvant chemotherapy were 72% and 43%, respectively, which was the result of factory case selection bias.