Clinical diagnosis and treatment experience with primary retroperitoneal tumors: report of 122 cases_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

HUO Mingke , LIU Yingjun , DONG Zhichuang , HAN Guangsen ,  HUA Kelei

Department of General Surgery, Affiliated Cancer Hospital of Zhengzhou University / Henan Cancer Hospital, Zhengzhou 450008, P. R. China;

Corresponding?author：

HUA Kelei, Email: huakelei@163.com

Keywords：

primary retroperitoneal tumor; surgical treatment; combined organ resection

DOI：

10.7507/1007-9424.202511102

Video：

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Objective To summarize the strategies for determining resectability, intraoperative tumor management techniques, and perioperative risk control in primary retroperitoneal tumors (PRT), so as to ensure patient safety during the perioperative period and achieve favorable outcomes. Methods A retrospective analysis was conducted on the clinical data of 122 patients with PRT who underwent surgical treatment at the Affiliated Cancer Hospital of Zhengzhou University from March 2017 to March 2023. The treatment process, surgical strategies, and key points of perioperative management were analyzed, and the clinical characteristics and perioperative management experience of this disease were summarized. And the influencing factors of postoperative complications were analyzed. Results All 122 PRT received comprehensive imaging evaluation before surgery. After postoperative pathological diagnosis, 105 cases were malignant and 17 were benign. Among them, 10 underwent simple biopsy, 31 underwent simple tumor resection, and 81 underwent combined organ resection. The following factors were associated with a higher probability of postoperative complications: seeking medical attention due to symptoms (P=0.042), tumors predominantly located in the retrorenal space (P=0.015), tumors crossing the midline (P=0.002), incomplete tumor capsule (P=0.014), and tumors located in the pelvic cavity (P=0.023). Conclusions Contrast-enhanced CT and MRI are the primary modalities for preoperative diagnosis and evaluation of PRT. However, surgical risks are considerably higher in certain subgroups, including patients with symptomatic presentation, tumors in the retrorenal space or pelvis, tumors crossing the midline, or those with an incomplete capsule. Comprehensive perioperative assessment and targeted risk prevention are therefore critical to improving outcomes.

Citation： HUO Mingke, LIU Yingjun, DONG Zhichuang, HAN Guangsen, HUA Kelei. Clinical diagnosis and treatment experience with primary retroperitoneal tumors: report of 122 cases. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2026, 33(3): 362-366. doi: 10.7507/1007-9424.202511102 Copy

1.	郝純毅, 吳劍揮. 原發性腹膜后軟組織肉瘤診治中國專家共識(2019版). 中國實用外科雜志, 2019, 39(6): 526-532.
2.	苗成利, 黃梅, 陳小兵, 等. 多原發性腹膜后脂肪肉瘤的治療及預后. 中華腫瘤雜志, 2021, 43(6): 674-677.
3.	Park S, Kim HS. Primary retroperitoneal mucinous carcinoma with carcinosarcomatous mural nodules: a case report with emphasis on its histological features and immunophenotype. Diagnostics (Basel), 2020, 10(8): 580. doi: 10.3390/diagnostics10080580.
4.	Tropea S, Mocellin S, Damiani GB, et al. Recurrent retroperitoneal sarcomas: clinical outcomes of surgical treatment and prognostic factors. Eur J Surg Oncol, 2021, 47(5): 1201-1206.
5.	霍明科, 韓廣森, 任瑩坤, 等. 腹膜后脂肪肉瘤患者首次外科切除后無進展生存期的影響因素及預后分析. 中華普通外科雜志, 2019, 34(5): 389-392.
6.	查立超, 李修霞, 周斌, 等. 原發性腹膜后肉瘤預后研究進展. 腹部外科, 2020, 33(4): 314-316.
7.	郭麗娜, 李云超, 孫占峰, 等. 影響原發性腹膜后腫瘤手術患者預后的危險因素分析. 世界華人消化雜志, 2021, 29(9): 461-466.
8.	Cuen-Ojeda C, Rivera-Banuelos JH, Anaya-Ayala JE, et al. Retroperitoneal germ cell tumor resection with primary inferior vena cava reconstruction. Ann Vasc Dis, 2019, 12(2): 243-245.
9.	Cheng ZJ, Cheng Q, Gong JP, et al. Surgical treatment of huge primary retroperitoneal tumor: a report of 14 cases. Am J Cancer Prev, 2016, 4(4): 64-69.
10.	馮元春, 李卿瑞, 張蔚, 等. 多層螺旋CT對原發性腹膜后腫瘤的評估價值研究. 中國醫學裝備, 2021, 18(2): 9-13.
11.	陳秀琴, 宋瑞祥. CT、MRI診斷腹膜后原發性腫瘤的臨床價值. 臨床醫學研究與實踐, 2020, 5(36): 140-141.
12.	龐北川, 張娜, 楊沖, 等. 原位自體腎移植聯合下腔靜脈切除重建在腹膜后腫瘤中的應用. 中國普外基礎與臨床雜志, 2022, 29(8): 1018-1023.
13.	唐茂盛, 苗成利, 陳小兵, 等. 累及下腔靜脈腹膜后腫瘤患者行下腔靜脈部分整段切除免重建術式的安全性評估. 第二軍醫大學學報, 2021, 42(6): 693-697.
14.	夏鐵男, 劉金鑫, 陳挺, 等. 混合現實技術在腹膜后腫瘤手術中的應用. 中國臨床研究, 2021, 34(8): 1053-1056.
15.	張曉璐, 劉曉艷, 黃靖, 等. 腹膜后腫瘤患者術后并發癥發生情況及預測模型構建. 中國普外基礎與臨床雜志, 2023, 30(2): 198-203.
16.	霍明科, 韓廣森, 趙玉洲. 開腹減壓后擇期行腹膜后巨大脂肪肉瘤切除一例. 臨床外科雜志, 2017, 25(3): 240.
17.	陳繼貴, 趙昌, 陳超, 等. 腹膜后脂肪全切除術治療復發性腹膜后脂肪肉瘤4例并文獻復習. 中國癌癥防治雜志, 2020, 12(6): 686-690.
18.	謝學海, 陳依然, 馬永蔌, 等. 腹腔鏡經腹入路和經腹膜外入路在腎下極水平以上原發性腹膜后腫瘤切除術中的應用. 中國微創外科雜志, 2019, 19(3): 232-235.
19.	Gorji L, Nikahd M, Onuma A, et al. Comparing multivisceral resection with tumor-only resection of liposarcoma using the win ratio. Ann Surg Oncol, 2024, 31(5): 3389-3396.

1. 郝純毅, 吳劍揮. 原發性腹膜后軟組織肉瘤診治中國專家共識(2019版). 中國實用外科雜志, 2019, 39(6): 526-532.
2. 苗成利, 黃梅, 陳小兵, 等. 多原發性腹膜后脂肪肉瘤的治療及預后. 中華腫瘤雜志, 2021, 43(6): 674-677.
3. Park S, Kim HS. Primary retroperitoneal mucinous carcinoma with carcinosarcomatous mural nodules: a case report with emphasis on its histological features and immunophenotype. Diagnostics (Basel), 2020, 10(8): 580. doi: 10.3390/diagnostics10080580.
4. Tropea S, Mocellin S, Damiani GB, et al. Recurrent retroperitoneal sarcomas: clinical outcomes of surgical treatment and prognostic factors. Eur J Surg Oncol, 2021, 47(5): 1201-1206.
5. 霍明科, 韓廣森, 任瑩坤, 等. 腹膜后脂肪肉瘤患者首次外科切除后無進展生存期的影響因素及預后分析. 中華普通外科雜志, 2019, 34(5): 389-392.
6. 查立超, 李修霞, 周斌, 等. 原發性腹膜后肉瘤預后研究進展. 腹部外科, 2020, 33(4): 314-316.
7. 郭麗娜, 李云超, 孫占峰, 等. 影響原發性腹膜后腫瘤手術患者預后的危險因素分析. 世界華人消化雜志, 2021, 29(9): 461-466.
8. Cuen-Ojeda C, Rivera-Banuelos JH, Anaya-Ayala JE, et al. Retroperitoneal germ cell tumor resection with primary inferior vena cava reconstruction. Ann Vasc Dis, 2019, 12(2): 243-245.
9. Cheng ZJ, Cheng Q, Gong JP, et al. Surgical treatment of huge primary retroperitoneal tumor: a report of 14 cases. Am J Cancer Prev, 2016, 4(4): 64-69.
10. 馮元春, 李卿瑞, 張蔚, 等. 多層螺旋CT對原發性腹膜后腫瘤的評估價值研究. 中國醫學裝備, 2021, 18(2): 9-13.
11. 陳秀琴, 宋瑞祥. CT、MRI診斷腹膜后原發性腫瘤的臨床價值. 臨床醫學研究與實踐, 2020, 5(36): 140-141.
12. 龐北川, 張娜, 楊沖, 等. 原位自體腎移植聯合下腔靜脈切除重建在腹膜后腫瘤中的應用. 中國普外基礎與臨床雜志, 2022, 29(8): 1018-1023.
13. 唐茂盛, 苗成利, 陳小兵, 等. 累及下腔靜脈腹膜后腫瘤患者行下腔靜脈部分整段切除免重建術式的安全性評估. 第二軍醫大學學報, 2021, 42(6): 693-697.
14. 夏鐵男, 劉金鑫, 陳挺, 等. 混合現實技術在腹膜后腫瘤手術中的應用. 中國臨床研究, 2021, 34(8): 1053-1056.
15. 張曉璐, 劉曉艷, 黃靖, 等. 腹膜后腫瘤患者術后并發癥發生情況及預測模型構建. 中國普外基礎與臨床雜志, 2023, 30(2): 198-203.
16. 霍明科, 韓廣森, 趙玉洲. 開腹減壓后擇期行腹膜后巨大脂肪肉瘤切除一例. 臨床外科雜志, 2017, 25(3): 240.
17. 陳繼貴, 趙昌, 陳超, 等. 腹膜后脂肪全切除術治療復發性腹膜后脂肪肉瘤4例并文獻復習. 中國癌癥防治雜志, 2020, 12(6): 686-690.
18. 謝學海, 陳依然, 馬永蔌, 等. 腹腔鏡經腹入路和經腹膜外入路在腎下極水平以上原發性腹膜后腫瘤切除術中的應用. 中國微創外科雜志, 2019, 19(3): 232-235.
19. Gorji L, Nikahd M, Onuma A, et al. Comparing multivisceral resection with tumor-only resection of liposarcoma using the win ratio. Ann Surg Oncol, 2024, 31(5): 3389-3396.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical diagnosis and treatment experience with primary retroperitoneal tumors: report of 122 cases

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