RETROPERITONEAL TUMORS - DO THE SATELLITE TUMORS MEAN SOMETHING

Background and Objectives: Primary retroperitoneal tumors constitute a rather uncommon disease with an incidence of 2 in 100,000. Local recu rrence after surgical resection is reported between 60% and 90% at 10 yr. The aim of this study was to present the problem of satellite tumo rs around the main tumor mass and their possible relation to local rec urrence. Methods: Twenty-nine patients with retroperitoneal tumors und erwent surgical resection in our department during an 8-yr period. We reviewed their records including their preoperative computed tomograph y (CT) scans. Results: Twenty patients had ''complete'' resections req uiring seven nephrectomies, four colectomies, two splenectomies, and o ne appendectomy. In nine cases the resection was incomplete because of tumor invasion to vital structures. Histopathology revealed that the resected tumors were: liposarcomas (12), leiomyosarcomas (4), paragang liomas (5), malignant fibrous histiocytomas (3), other sarcomas (3), s chwannoma (1), myelolipoma (1), and the malignancy grade was I in 6, g rade II in 11, and grade III in 12 cases. Two patients died within 30 d of the operation. The 1 year recurrence rate was 41.4% (12/29) and t he total recurrence rate 55.2% (16/29). Survival at 5 yr was 31% (9/29 ), whereas the disease-free survival was 20.7% (6/29). Four patients r equired reoperations. In seven cases (24,1%) preoperative CT scans rev ealed small nodular lesions around the main tumor that were removed en bloc and were of the same histopathological type as the main tumor. W e called these ''satellite'' tumors. All seven patients had local recu rrence within 1 yr. Conclusions: There seems to be a close relationshi p between the finding of satellite tumors and the recurrence of the di sease. The existence of satellite tumors on the preoperative CT scan m ay be used as a guide for the extent of the resection, and further inv estigations are necessary before they are used as a prognostic sign. ( C) 1998 Wiley-Liss, Inc.