Retroperitoneal Tumors: Insight Gained Over a Decade in a Single Surgical Unit

Background: Retroperitoneal tumors (RPTs) are uncommon but varied types of neoplasms, representing 0.1-0.2% of all cancers. They can range from benign to being highly malignant. A significant portion of RPTs are malignant (70–80%), with the majority being sarcomas. Roughly 20% of these tumors are benign, and most retroperitoneal tumors tend to be quite large by the time they are detected. The management of these tumors poses challenges due to their size, intricate anatomy, and their closeness to vital organs and blood vessels. This study intends to share our experiences in dealing with retroperitoneal neoplasms and to provide a detailed understanding of their clinical presentation, surgical management, and outcomes. Methods: A total of 54 patients diagnosed with retroperitoneal tumors were treated in a single gastrointestinal surgery unit from January 2010 to December 2023. We retrospectively analysed the prospectively maintained data of these patients. Results: The median age of the patients was 50 years, with an age range of 15 to 86 years. The ratio of males to females was 33:21. The most frequently reported symptom was abdominal pain, observed in 33 instances (61.2%). The average size of the tumors measured 17.3 cm in diameter, with a range from 7.0 to 36.0 cm. 46 patients (85.1%) underwent surgical resection. Complete resection (R0 resection) was achieved in 41 patients (75.9%). Five patients (9.2%) received debulking procedures for surgical palliation, while eight patients (14.9%) were considered for palliative chemotherapy. Additionally, nine cases (16.6%) necessitated the resection of adjacent organs.The median duration of the surgical procedure was 210 minutes (60-310 minutes). Postoperatively, the median length of hospital stay was 7 days (2 to 37 days). The median follow-up period lasted 62 months (3 to 102 months). Recurrences were noted in 5 patients (9.2%). Median overall survival duration of the patients with malignancy was 58.5 months (12-130 months). Overall suvival was highest for patients with liposarcoma and grade 1 tumors. Conclusion: RPTs are challenging to manage because of their location, locally advanced nature, and heterogeneous pathology. Preoperative imaging is essential for adequate surgical planning. Complete surgical resection is the cornerstone of RPT management and has the potential for curative treatment. Survival rates are better for liposarcoma and Grade I tumors. Given the infrequency of RPTs, there is a necessity for more collaborative research to more precisely determine the best approach to treating these tumors, including the use of perioperative chemoradiotherapy.