Background: RPS are rare tumors requiring complex surgery. The impact of postoperative complications on long-term outcomes is still debated. This study aimed to identify predictors of severe complications and assess their influence on overall survival (OS) and disease-free survival (DFS). Methods: We retrospectively analyzed 61 patients who underwent curative surgery for primary RPS between 2013 and 2023 at a tertiary cancer center. Patients with pelvic or recurrent sarcomas were excluded. Severe complications were defined as Clavien–Dindo (CD) grade ≥ 3A. Cox regression and Fine–Gray competing risk models were used for OS and DFS, respectively. Sarculator and P-POSSUM scores were included in multivariable models. Results: Severe complications occurred in 14.8% of patients; 30-day mortality was 1.6%. Predictive factors for complications included longer operative time, gastric resection, intraoperative complications, and transfusions. In multivariable analysis, Sarculator was significantly associated with both DFS (HR 0.97;p= 0.004) and OS (HR 0.97;p= 0.008). The P-POSSUM mortality score predicted OS (HR 1.12;p= 0.002). Severe complications were not independently associated with DFS or OS. Conclusions: In this cohort, severe complications did not impact long-term oncological outcomes. Prognostic tools such as Sarculator and P-POSSUM may enhance risk stratification in RPS surgery. Prospective validation is warranted.
背景：原发性腹膜后肉瘤（RPS）是一种罕见肿瘤，需接受复杂手术治疗。术后并发症对长期预后的影响尚存争议。本研究旨在识别严重并发症的预测因素，并评估其对总生存期（OS）和无病生存期（DFS）的影响。 方法：我们回顾性分析了2013年至2023年间在某三级癌症中心接受根治性手术的61例原发性RPS患者。盆腔肉瘤或复发性肉瘤患者被排除在外。严重并发症定义为Clavien-Dindo（CD）分级≥3A级。分别采用Cox回归模型和Fine-Gray竞争风险模型评估OS和DFS。多变量模型中纳入了Sarculator和P-POSSUM评分系统。 结果：14.8%的患者发生严重并发症；30天死亡率为1.6%。并发症的预测因素包括较长手术时间、胃切除、术中并发症及输血。多变量分析显示，Sarculator评分与DFS（HR 0.97；p=0.004）和OS（HR 0.97；p=0.008）均显著相关。P-POSSUM死亡率评分可预测OS（HR 1.12；p=0.002）。严重并发症与DFS或OS无独立相关性。 结论：在本研究队列中，严重并发症未影响长期肿瘤学结局。Sarculator和P-POSSUM等预后评估工具有助于优化RPS手术的风险分层，但需前瞻性研究进一步验证。
肿瘤(癌症)患者之家