Diagnosis and Analysis of Retroperitoneal Tumor Combined with Digestive Tract Resection: A Retrospective Study

Purpose The surgical management of retroperitoneal tumors involving digestive tract resection remains controversial.. This study examined cases of retroperitoneal tumors requiring concomitant digestive tract resection, with analysis focused on postoperative complication rates, prognostic outcomes, and histopathologic organ invasion (HOI) of resected organs, aiming to provide evidence to guide surgical decision-making. Methods We retrospectively analyzed the clinical data of 119 patients who underwent retroperitoneal tumor surgery with concomitant digestive tract resection at our institution between January 2018 and December 2023. Results The most common resection sites were the large intestine (41.2%), small intestine (30.3%), and both (17.6%). HOI was identified in 32.8% of resected organs. The rate of severe complications (Clavien-Dindo ≥ III) was 15.1%, with intra-abdominal infections occurring more frequently following colectomy. Complete resection (R0/R1) was achieved in 108 cases (90.8%). For 99 malignant cases, the 3- and 5-year overall survival rates were 76.5% and 73.0%, respectively. Multivariable Cox analysis identified tumor size, resection margin status (R0/R1 vs. R2), and HOI as independent risk factors for overall survival (P < 0.05), and tumor size, resection margin status, recurrence, and HOI as independent risk factors for disease-free survival (P < 0.05). Conclusion In this retrospective cohort, retroperitoneal tumor resection combined with digestive tract resection was associated with acceptable postoperative morbidity and facilitated complete tumor removal in a high proportion of cases. The complication profile was broadly consistent with rates reported by major international sarcoma registries. These findings suggest that, in appropriately selected patients—particularly those with suspected organ invasion on intraoperative assessment—combined digestive tract resection is a feasible strategy to achieve complete resection. However, given the limitations of this single-center retrospective study, our results should be interpreted cautiously and validated in larger, prospective, multi-institutional cohorts.