Diagnosis and surgical treatment of primary retroperitoneal tumors: report of 63 cases / 中华普通外科杂志

ABSTRACT

Objective To evaluate the experience in the diagnosis and surgical treatment of primary retroperitoneal tumor (PRT). Methods Clinical data of PRT 63 cases from January 1990 to March 2007 confirmed by pathology were retrospectively analyzed including clinical manifestation, surgical procedures, pathological examination and follow-up. Results Tumors were benign in 25 patients and malignant in 38. The main symptoms and signs were abdominal mass. The Youdon's index of CT examination for distinguishing benign from malignant tumors was 85%. The complete surgical resection rate was 88% for benign tumors and 68% for malignances. Removal of the involved organs or vessels was needed in 40% patients in complete surgical resection group. Postoperative recurrence was high in those the tumor was not completely removed and those the tumor was malignant. The 5-year survival rate for complete surgical resection of benign tumors was 83.6% ,and that of malignant tumors was 27.3%. After a median follow-up of 36 months (range 5 ～ 168)for the resection of malignant tumors, the local recurrence rate was 53%. Median time between initial surgery and recurrence was 25 months (range 3 ～ 108). For local recurrence of malignant tumor, the complete surgical resection rate was 62.5%. One patient died of intraabdominal hemorrhage in the first day after operation. Conclusion For PRT patients, early diagnosis is often difficult. Preoperative imaging results are essential to predict the surgical resectability. The optimal treatment of patients with PRT is radical resection, an bloc organ resection if necessary. Regularly postoperative follow-up is mandatory for early finding recurrence.