Treatment of primary retroperitoneal tumors: Single center experience

Yıl 2023, Cilt: 6 Sayı: 3, 479 - 482, 31.12.2023

Umut Ünal , Kadir Karkin , Ediz Vuruşkan , Mubariz Aydamirov

https://doi.org/10.36516/jocass.1401282

Öz

Introduction: The aim of our study is to evaluate the results of patients who underwent surgery due to primary retroperitoneal tumors in order to contribute to the knowledge pool in the literature.
Material Method: The data of patients who underwent surgery due to retroperitoneal tumor at Health Sciences University, Adana City Training and Research Hospital between January 2015 and January 2023 were retrospectively scanned. Approximately 54 patients with a clinical diagnosis of PRT were included in the study. Preoperative demographic characteristics of the patients, such as age at diagnosis, gender, number of surgeries for PRT, preoperative biopsy pathology and symptom status, if any, were recorded. All patients underwent computed tomography (CT) imaging with intravenous contrast. The location, size, density and presence of contrast enhancement of PRT in preoperative imaging methods were recorded. Peroperative incision type and duration, need for erythrocyte suspension transfusion, need for organ resection, complications and length of stay in the postoperative period were evaluated.
Results: The average age of a total of 54 patients who underwent surgery due to a retroperitoneal mass was 53.8±10.0 years. While 15 (27.8%) of 54 patients with a retroperitoneal mass were diagnosed incidentally, 39 (72.2%) patients were diagnosed symptomatically. The final pathological outcome of all relapsed patients was liposarcoma. The average operation time was 178.7±85.4 minutes. In 12 (22.2%) patients, adjacent organ resection was performed in addition to the mass. The average length of stay of the patients was 6.2±3.1 days. In the postoperative period, one patient required re-operation due to ileus and one patient due to bleeding. Adjuvant therapy was given to 6 (11.1%) patients after surgery. In the final pathology results of the patients, positive surgical margins were detected in 8 (14.3%) patients. Additionally, all of these patients had organ resection. In the Kaplan-Meier survival analysis, it was found that surgical margin had a statistically significant effect on average survival (p<0.001).
Conclusion: According to the results of our study, microscopic surgical margin positivity is the main factor affecting survival in PRT treatment and that total organ resection positively affects survival.

Anahtar Kelimeler

primary retroperitoneal tumors, surgical resection, effective treatment

Kaynakça

• 1. An JY, Heo JS, Noh JH. Primary malignant retroperitoneal tumors: analysis of a single institutional experience. Eur J Surg Oncol. 2007; 33(3):376-82.
• 2. Czeyda-Pommersheim F, Menias C, Boustani A, et al. Diagnostic approach to primary retroperitoneal pathologies: what the radiologist needs to know. Abdom Radiol (NY). 2021; 46(3):1062-1081.
• 3. Gyorki DE and Brennan MF. Management of recurrent retroperitoneal sarcoma. J Surg Oncol. 2014; 109(1): 53-9.
• 4. Xu YH, Guo KJ, Guo RX, et al. Surgical management of 143 patients with adult primary retroperitoneal tumor. World J Gastroenterol. 2007; 13(18): 2619-21.
• 5. Testini M, Catalano Jr G, Macarini L, et al. Diagnosis and surgical treatment of retroperitoneal tumours. Int Surg. 1996; 81(1): 88-93.
• 6. Schwarzbach MHM, Hormann Y, Hinz U, et al. Clinical results of surgery for retroperitoneal sarcoma with major blood vessel involvement. J Vasc Surg. 2006; 44(1): 46-55.
• 7. Ferrario T. and Karakousis CP. Retroperitoneal sarcomas: grade and survival. Arch Surg. 2003; 138(3): 248-51.
• 8. Lee F, Huang TS, Ng XY, et al. Surgical management of primary retroperitoneal tumors–analysis of a single center experience. Journal of Cancer Research and Practice. 2017; 4(2): 49-52.
• 9. Gemici K, Buldu İ, Acar T, et al. Management of patients with retroperitoneal tumors and a review of the literature. World J Surg Oncol. 2015; 13:143.
• 10. Bautista N, Su W, O'Connell TX. Retroperitoneal soft-tissue sarcomas: prognosis and treatment of primary and recurrent disease. Am Surg. 2000; 66(9): 832-6.
• 11. Neville A and Herts BR. CT characteristics of primary retroperitoneal neoplasms. Crit Rev Comput Tomogr. 2004; 45(4): 247-70.
• 12. Rajiah P, Sinha R, Cuevas C, et al. Imaging of uncommon retroperitoneal masses. Radiographics. 2011; 31(4): 949-76.
• 13. Kattan MW, Leung DH, Brennan MF. Postoperative nomogram for 12-year sarcoma-specific death. J Clin Oncol. 2002; 20(3): 791-6.
• 14. Lewis JJ, Leung D, Woodruff JM, et al. Retroperitoneal soft-tissue sarcoma: analysis of 500 patients treated and followed at a single institution. Ann Surg. 1998; 228(3): 355-65.
• 15. Tirotta F, Bacon A, Collins S, et al. Primary retroperitoneal sarcoma: A comparison of survival outcomes in specialist and non-specialist sarcoma centres. Eur J Cancer. 2023; 188: 20-28.