Surgeons at a Nashik-based hospital completed a nine-hour marathon surgery to remove a massive 15-kilogram retroperitoneal tumour, demonstrating remarkable medical competence. The patient, a 61-year-old male from Dhule, has already had four cancer recurrences, making this procedure very challenging and unusual. 

Retroperitoneal sarcomas are tumours that develop behind the abdominal organs. Despite their rarity, they are known to recur even after therapy. According to a 2023 review in The Lancet Oncology, these sarcomas make up only 10-15% of all soft tissue sarcomas but provide significant issues due to their location and frequent involvement of vital structures. 

"Retroperitoneal sarcomas are both rare and aggressive tumours.ach recurrence increases the likelihood of organ involvement and scarring. Dr Raj Nagarkar of HCG Manavata Cancer Centre, who headed the surgical team, explained that while total removal improves survival, it is technically demanding. 

In this particular case, the tumour had expanded across the belly, attaching to the small bowel tissue that supports the intestines (mesentery) and infecting the pelvis, lesser sac, and larger sac. The procedure involved removing a portion of the small intestine, connecting the ends back together and reconstructing the common iliac vein, a significant blood supply. 

“We accomplished a ‘R0 resection’, meaning that no cancer cells remained at the surgical edges. This is crucial because studies suggest that R0 resections have significantly higher survival rates. For example, a 2022 study in the Annals of Surgical Oncology reported that 5-year survival after R0 resection was approximately 60%, compared to fewer than 20% for residual disease. 

The teamwork of surgical oncology, vascular surgery, and critical care distinguished this case. Dr Nagarkar stated that operating on a massive, recurring tumour after four previous surgeries requires precise planning and execution. “Our goal is to assist the patient to recuperate rapidly while simultaneously removing the malignancy," he added.

The hospital sources said that the patient received discharge seven days after the surgery. His speedy recovery is part of what doctors refer to as "enhanced recovery protocols", which combine pain management, early eating, and mobilisation to reduce hospital stays. 

Interestingly, a meta-analysis published in the BMJ Open in 2021 demonstrates that these protocols reduce complications and hospitalisation times following major abdominal surgery. 

South Asia presents multiple distinct obstacles in cancer treatment. Late diagnosis, restricted access to specialised surgical teams, and high out-of-pocket expenses all complicate therapy. According to the Indian Journal of Cancer in 2023, fewer than 15% of soft tissue cancer patients in India receive treatment in high-volume centres with multidisciplinary competence, which has been shown to enhance results. 

This case demonstrates what is achievable when improved surgical planning, interdisciplinary teamwork, and patient-centred recovery are combined – even in resource-constrained environments. It also highlights the importance of increasing access to such expertise throughout South Asia. 

"Beyond the technical triumph, our duty is to restore hope. When a patient survives four recurrences, our goal isn't only to operate; it's to restore their life,” Dr Nagarkar summarised.