Primitive retroperitoneal tumors. Vascular involvement--a major prognostic factor.
Primitive retroperitoneal tumors, although very rare, arouse an increased interest, because of the poor prognosis, unsatisfactory surgical and complementary therapy results. Up to now, the very low number of cases has impeded the acquisition of a unitary view of these tumors, a unanimously accepted algorithm of diagnostic and treatment being absent. Randomized trials regarding the effects of different therapies have not been possible. The main factor that can fundamentally increase the survival of these patients is radical resection, some authors even recommending compartmental surgery. We found no significant statistical difference between the survival rates of the patients with different types of non-radical interventions, that shoud be therefore, as much as possible, avoided. Our study evidences that vascular involvement is the main limiting factor in achieving radicality. The involvement of large retroperitoneal vessels makes often impossible a radical intervention, usually because of the lack of an adequate material and human endowment for ample vascular resections followed by laborious reconstructions. That is why, in our study, vascular involvement was associated with a decreased survival rate for operated patients. Therefore, we underline the necessity both of a solid material base and of establishing multidisciplinary surgical teams for adequate vascular interventions in oncologic general surgery.
Clinic of Surgery I, Bucharest Oncology Institute Al. Trestioreanu, University of Medicine and Pharmacy Carol Davila, Bucharest Romania. angelalazar.2008@yahoo.com
A M
AM
Lazar
E
E
Brătucu
N D
ND
Straja
C
C
Daha
M
M
Marincaş
C
C
Cirimbei
V
V
Prunoiu
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D042241:Early Diagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011379:Prognosis; D011446:Prospective Studies; D012186:Retroperitoneal Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D012187:Retroperitoneal Space / Q000098:blood supply; D012189:Retrospective Studies; D012383:Romania / Q000453:epidemiology; D015996:Survival Rate; D016896:Treatment Outcome; D019043:Vascular Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D014654:Vascular Patency