[Clinical analysis of diagnosis and treatment for retroperitoneal malignant fibrous histiocytoma].

ABSTRACT

OBJECTIVE: To explore the clinical characteristics of retroperitoneal malignant fibrous histiocytoma (MFH) and to retrospectively evaluate the outcome of treatment and identify prognostic factors for survival time. METHODS: The records of 38 patients with retroperitoneal malignant fibrous histiocytoma (MFH) managed with surgery from March 2000 to August 2013 were retrospectively reviewed. RESULTS: All patients received surgical resection, including 23 primary tumors and 15 recurrent tumors. 20 patients received radical resection, 18 cases received palliative resection. The 19 patients (95%) received complete resection got tumor recurrence. The overall 1-, 3-,5-year survival rate were 62. 9%, 35. 2% and 4. 4% and the median survival time was 15. 5 (1 - 157) months. Log-rank test indicated that tumor grade (χ2 = 10. 667, P <0. 01) and radical surgery(χ2 =.18. 476, P <0. 01) were associated with postoperative survival time. The difference between gender(χ2 = 3. 329, P = 0 . 068), age (χ2 = 0. 426, P = 0. 514), removal of the joint organs(χ2 = 3. 725, P = 0. 054), blood transfusion (χ2 = 0. 044, P = 0. 833), tumor size (χ2 = 1. 647, P =0. 199), tumor metastasis(χ2 =0. 345, P =0. 557), adjuvant therapy(χ2 = 1. 992, P =0. 158), recurrent disease (χ2 = 0. 163, P = 0. 640)got no statistical significance. Multivariate analysis indicated that radical surgery and tumor grade were prognostic indicators for retroperitoneal malignant fibrous histiocytoma (RR =4.888, P =0. 001; HR =4. 436, P =0. 006). CONCLUSIONS: Malignant fibrous histiocytoma (MFH) has high malignant degree and is difficult to treat. The prognosis is poor. Complete resection remains the main method for retroperitoneal malignant fibrous histiocytoma. It often requires the resection of other adjacent organs in order to reach the goal of radical resection. Incomplete resection and high grade(grade 3) predict shorter postoperative survival time.