Prognostic Factor Analysis and Nomogram Construction of Primary Retroperitoneal Liposarcoma: A Review of 10 Years of Treatment Experience in a Single Asian Cohort of 211 Cases

ObjectiveThis study intended to retrospectively analyze the data of patients with primary retroperitoneal liposarcoma in a single Asian large-volume sarcoma center and to establish nomograms focused on PRLPS for predicting progression-free survival (PFS) and overall survival (OS).MethodsA total of 211 patients treated surgically for primary, non-metastatic retroperitoneal liposarcoma during 2009–2021 were identified, and clinicopathologic variables were analyzed. PFS and OS nomograms were built based on variables selected by multivariable analysis. The discriminative and predictive ability of the nomogram was assessed by concordance index and calibration curve.ResultsThe median follow-up time was 25 months. A total of 117 (56%) were well-differentiated, 78 (37%) were dedifferentiated, 13 (6%) were myxoid, and 3 (1%) were pleomorphic morphology. Compared to the western population cohort reported by the Memorial Sloan-Kettering Cancer Center, the median age of patients in this cohort was younger (57 vs. 63 years), the tumor burden was lower (20 vs. 26 cm), and the proportion of patients with R0 or R1 resection was higher (97% vs. 81%). The 5-year PFS rate was 49%, and factors independently associated with PFS were symptoms at visit, preoperative needle biopsy, histologic subtypes, and postoperative hospital stay. The 5-year OS rate was 72%. American Society of Anesthesiologists Physical Status and Clavien-Dindo classification were independently associated with OS. The concordance indexes for PFS and OS nomograms were 0.702 and 0.757, respectively. The calibration plots were excellent.ConclusionsThe proposed nomogram provided a favorable reference for the treatment of primary retroperitoneal liposarcoma patients.

Sonographic approach to the tumours of retroperitoneal space

Background: Timely diagnosis of primary retroperitoneal tumours is one of the current challenges of clinical oncology. This is due to the rarity, polymorphism and diagnostic difficulties of primitive retroperitoneal tumours. Material and methods: The study is cross-sectional, prospective and retrospective. The study group is represented by 118 patients with abdominal and retroperitoneal space tumours. Using the receiver operating characteristic (ROC) analysis curve and calculating the average quality of the diagnostic model, the informativeness of ultrasonography in the diagnosis of primary retroperitoneal tumours (PRT) was appreciated. Results: For tumour localization, the ultrasonography (USG) as a diagnostic model demonstrated an appropriate use criteria (AUC) of 0.641 (95% CI 0.541, 0.740, p <0.001), and the mean quality of the diagnostic model was 0.54. Following the statistical analysis, was found a partial correlation between the size of the tumour and the dimensions estimated at USG of 0.540 (95% CI 0.295, 0.737, p <0.001), which represents a high positive correlation. To determine the uni- or multicentric character of the tumour, the USG demonstrated an integrative value of sensitivity and specificity of 0.644 (95% CI 0.415, 0.873, p <0.001. In assessing the proximity ratio of retroperitoneal tumours, the highest AUC was recorded in the assessment of the ratio of tumour to pancreas – 0.838 (95% CI 0.705.0.971, p <0.001) and kidney – 0.861 (95% CI 0.699, 1.024, p <0.001). Conclusions: Ultrasonography is a fairly informative imaging diagnostic method in the diagnosis of retroperitoneal tumours. The characteristics of the tumours obtained after the ultrasound examination provide indirect information about the malignant or benign nature of the primitive tumour, which allows the assessment of the next stages of diagnosis and treatment.

Primary retroperitoneal liposarcoma: a rare case report

Primary retroperitoneal liposarcoma (PRPLS) is a rare malignant tumor with a low incidence. A 34-year-old female patient presented to our department with abdominal pain, nausea, and vomiting for 2 days. Abdominal computed tomography (CT) indicated a huge mass between the liver and kidney, with a clear boundary and measuring approximately 202 mm × 155 mm ×106 mm. The mass was considered a retroperitoneal lipoma or liposarcoma. The entire tumor was completely resected without auxiliary injury, and histopathology of the resected specimen indicated liposarcoma. The patient recovered well and was discharged from our department on the 6th postoperative day. No signs of relapse were seen during 1-year of follow-up. PRPLS is rare and without obvious symptoms in the early stage. CT plays a vital role in the diagnosis of PRPLS, and surgical resection is considered the most suitable treatment. Radiotherapy and chemotherapy might also be treatment options to improve the overall survival of PRPLS patients.

Idiopathic Primary Retroperitoneal Cyst: A Case Report

Retroperitoneal cysts are rare; they are divided into neoplastic and non-neoplastic cyst. Incidences are 1 in 5750 to 1 in 250,000. They are often asymptomatic. Lymphangioma are benign cyst whereas 95% of them are found in the neck and axilla only 1% is in the abdomen. This is a case report describing the course of management for a 30-year-old male who presented to our outpatient clinic with abdominal discomfort due to retroperitoneal cyst.

Large primary retroperitoneal mucinous cystadenoma managed laparoscopically: Case report and literature review

Background: Retroperitoneal cystic lesions (RCLs) are uncommon clinical findings that arise within the retroperitoneal compartments and account for various etiologies. They can be benign or malignant in nature and may present with different manifestations. Case report: A 55-year-old woman presented with nonspecific right sided abdominal pain. Ultrasound detected a large cyst in the right retroperitoneal region, computed tomography revealed a large well-defined cystic lesion measuring 13 X 9 X 6 cm in the right posterior peritoneum extending from the subhepatic area to the right pelvis. Laparoscopic complete resection performed with uneventful perioperative course. Histopathologic findings were suggestive of mucinous cystadenoma. Conclusion: Primary Retroperitoneal Mucinous Cystadenoma (PRMC) is an extremely rare pathology that can pose some challenge for clinicians. Awareness of this entity can help us in establishing the diagnosis and provide an optimal management. Although laparotomy is considered the standard approach of huge mucinous cystadenomas; laparoscopic surgery can be a safe and adequate therapeutic option. Keywords: retroperitoneal cystic lesions (RCL); primary retroperitoneal mucinous cystadenomas (PRMCs); cystadenoma; mucinous; laparoscopy.