title: Management of patients with retroperitoneal tumors and a review of the literature.
abstract: BACKGROUND
  Retroperitoneal tumors (RTs) develop insidiously and are generally seen as large masses, and 50% of RTs are larger than 20 cm at the time of diagnosis. In this article, we share our experience of 5 years of surgical management of RTs.
  
  
  METHODS
  We evaluated 28 RT cases operated on in three education hospitals in Turkey from January 2008 onwards, with regard to patients' demographic characteristics, complaints, weight loss figures, the location and size of the tumor, blood transfusion, intra-operational time, metastases (in malignant cases), additional organ resection, histological grade, local recurrences, average life expectancy, and post-operative treatment methods.
  
  
  RESULTS
  The mean age of the patients was 49 years (range, 18 to 78 years). Twenty (71.43%) were female, and 8 (28.57%) were male. The primary complaint was abdominal pain in 18 patients (64.28%). CT scans were performed in 17 (61%) patients, 10 (35.4%) underwent abdominal MR imaging, and 1 (3.6%) underwent both abdominal CT and abdominal MR imaging. A mass was palpated in the pelvis (suprapubic region) in seven (25%) of the patients during physical examination. The largest tumors were detected in the left lumbar area. The mean tumor size was 12.78 cm (range, 2 to 30 cm). The mean intra-operational time was 192 min (range, 70 to 380 min). The mean hospitalization period was 11 days (range, 8 to 23 days). Seven (25%) patients were reported to have benign tumors, while 21 (75%) were reported to have malignant tumors. The most frequently seen malignant pathology was liposarcoma (eight cases; 38.09%) followed by leiomyosarcoma (five cases; 23.8%) and malignant fibrous histiocytoma (four cases; 19.04%). The earliest local recurrence was detected in the 12th month and the latest in the 28th month. A total of 11 (52.3%) of the total of 21 malignant cases experienced local recurrence within 3 years. The 3-year average life expectancy was 85.7% in the 18 malignant cases.
  
  
  CONCLUSIONS
  Due to the low response rate of all but two types of RT to chemotherapy, the best remaining treatment option is surgery with wide resection margins, whereby all macroscopic traces of tumor are removed.
authors.affiliation: Faculty of Medicine, Department of General Surgery, Mevlana University, Konya, Turkey. drkazimgemici@hotmail.com.
authors.forename: Kazım
authors.initials: K
authors.lastname: Gemici
authors.affiliation: Faculty of Medicine, Department of Urology, Mevlana University, Konya, Turkey. ibrahimbuldu@yahoo.com.
authors.forename: İbrahim
authors.initials: İ
authors.lastname: Buldu
authors.affiliation: Faculty of Medicine, Department of Radiology, Mevlana University, Konya, Turkey. drtacar@hotmail.com.
authors.forename: Türker
authors.initials: T
authors.lastname: Acar
authors.affiliation: Faculty of Medicine, Department of Gynaecology, Mevlana University, Konya, Turkey. alptekinhusnu74@hotmail.com.
authors.forename: Hüsnü
authors.initials: H
authors.lastname: Alptekin
authors.affiliation: Konya Education and Research Hospital, Konya, Turkey. mekaynar@gmail.com.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Kaynar
authors.affiliation: Konya Education and Research Hospital, Konya, Turkey. etekinarslan81@hotmail.com.
authors.forename: Erdem
authors.initials: E
authors.lastname: Tekinarslan
authors.affiliation: Faculty of Medicine, Department of Urology, Mevlana University, Konya, Turkey. tunakaratag@gmail.com.
authors.forename: Tuna
authors.initials: T
authors.lastname: Karatağ
authors.affiliation: Faculty of Medicine, Department of Radiology, Mevlana University, Konya, Turkey. duranefe@hotmail.com.
authors.forename: Duran
authors.initials: D
authors.lastname: Efe
authors.affiliation: Faculty of Medicine, Department of General Surgery, Necmettin Erbakan University, Konya, Turkey. drhalduncolak@hotmail.com.
authors.forename: Haldun
authors.initials: H
authors.lastname: Çolak
authors.affiliation: Faculty of Medicine, Department of General Surgery, Necmettin Erbakan University, Konya, Turkey. tevfikkk75@hotmail.com.
authors.forename: Tevfik
authors.initials: T
authors.lastname: Küçükkartallar
authors.affiliation: Faculty of Medicine, Department of Urology, Mevlana University, Konya, Turkey. drokanist@gmail.com.
authors.forename: Mustafa Okan
authors.initials: MO
authors.lastname: İstanbulluoğlu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D051677:Histiocytoma, Malignant Fibrous / Q000473:pathology / Q000601:surgery*; D006760:Hospitalization; D006801:Humans; D007890:Leiomyosarcoma / Q000473:pathology / Q000601:surgery*; D008080:Liposarcoma / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D011379:Prognosis; D012186:Retroperitoneal Neoplasms / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D055815:Young Adult