PRONÓSTICO POSTQUIRÚRGICO DE NEOPLASIAS RETROPERITONEALES PRIMARIAS INTERVENIDAS EN EL HOSPITAL ONCOLÓGICO (SOLCA) DURANTE EL PERIODO 2010 – 2015

Abstract

Primary retroperitoneal tumors are neoplasms of low incidence, with no specific predisposition for any sex. There are several benign and malignant histological subtypes, however, the predominant is the malignant, different bibliographic series that report the case of these tumors report to Sarcoma as the main one. The only curative treatment demonstrated is surgery; however, there are cases in which, due to their relapsing nature, rapid tumor growth, incomplete resection, high risk of recurrence and poor post-surgical evolution require non-surgical treatment such as chemotherapy or radiation therapy. The median survival of retroperitoneal tumors at 5 years ranged from 50% to 74% in patients who underwent complete resection, from 8% to 35% who underwent partial resection and from 3% to 15% Which are not resectable. JUSTIFICATION: The purpose of this thesis is to determine if the treatment offered to each patient with primary retroperitoneal tumors positively influences overall survival, based on the cases presented in similar works of the world literature. OBJECTIVES: To determine the postoperative prognosis, the predominant histological subtype, the percentage of relapses and the overall and disease free survival of the primary retroperitoneal neoplasms operated at the Oncology Hospital (SOLCA) during the period 2010-2015. METHODOLOGY: An analysis Descriptive, observational and retrospective study, consisting of all patients who were diagnosed with primary retroperitoneal neoplasm through the respective imaging study, attended at the Solca Oncology Institute during the period January 2010 to January 2015. The analysis of the postsurgical survival of each patient was performed using the Kaplan Meier method and the comparison of survival curves using the long rank statistical test. RESULTS: Of a universe of 36 patients diagnosed, 72% were female and 28% male, predominating in children under 20 years of age with a mean age of 35 years. 69% of patients underwent tumor resection with 53% R0, 5% R1 and 11% R2. 19% of the tumors were benign and 81% malignant, the most common was leiomyosarcoma (22%) and liposarcoma (19%). Relapses corresponded to 58%, mainly in malignant tumors. 78% required adjuvant chemotherapy, XII radiation therapy or both. 33% of the patients had metastases mainly to the liver and lung. Survival was directly related to the degree of resection, overall survival was 67% at 12 months, 31% at 26 months, 14% at 60 months and 6% at 120 months. Patients with R0 resection have an overall survival of 21-73% at 5 years. CONCLUSION: The mean survival for malignant tumors is 12 months, with a survival rate of 10% at 5 years, and for benign tumors 100% from the year of diagnosis to the present. With 95% confidence, it can be inferred that the proportion of patients submitted to R0 who are alive at 60 months are between (21.2667% and 73.4139%) compared to the standard of 50% -74%. RECOMMENDATIONS: The results obtained in 5 years allow us to obtain a clear idea of the post-surgical prognosis in our environment, which compared with the world literature is similar both in the histopathological subtype and in the overall survival obtained, however, a larger universe of patients would allow to translate these data to the population, being able to infer the survival with greater security depending on the characteristic of each tumor. In the context of the research carried out, the data were similar to those of international studies. In Ecuador, no studies have been published evidencing the prognosis of this pathology, which gives it the necessary value to expand the universe of this work.