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The Role of Surgery Following Chemotherapy in Stage III Germ Cell Neoplasms

1983; Lippincott Williams & Wilkins; Volume: 129; Issue: 1 Linguagem: Inglês

10.1016/s0022-5347(17)51910-2

1527-3792

R. Bruce Bracken, Douglas E. Johnson, O.H. Frazier, Christopher J. Logothetis, Antonio Trindade, Melvin L. Samuels,

Sexual Differentiation and Disorders

No AccessJournal of Urology1 Jan 1983The Role of Surgery Following Chemotherapy in Stage III Germ Cell Neoplasms R. Bruce Bracken, Douglas E. Johnson, O. Howard Frazier, Christopher J. Logothetis, Antonio Trindade, and Melvin L. Samuels R. Bruce BrackenR. Bruce Bracken More articles by this author , Douglas E. JohnsonDouglas E. Johnson More articles by this author , O. Howard FrazierO. Howard Frazier More articles by this author , Christopher J. LogothetisChristopher J. Logothetis More articles by this author , Antonio TrindadeAntonio Trindade More articles by this author , and Melvin L. SamuelsMelvin L. Samuels More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)51910-2AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Abstract: After curative chemotherapy 58 patients with metastatic germinal tumors and 2 with extragonadal germinal tumors underwent an operation either to confirm a clinical complete response or to remove a residual mass. Biomarker status was converted to negative in all patients. Retroperitoneal lymphadenectomy was done in 22 patients after a complete clinical response was achieved and in 23 after an apparent complete response was achieved except for a residual retroperitoneal mass. Thoracotomy was done for a residual mass in 13 patients, while 2 underwent bilateral thoracotomy. Scarring was found in 25 patients (42 per cent), teratoma in 14 (23 per cent) and active tumor in 17 (28 per cent). One patient with scarring and primary seminoma died of disseminated seminoma, while 1 with primary teratocarcinoma died of disseminated disease, for a false negative rate of 3 per cent. Four patients with a residual mass showed unexpected findings: 2 had granulomas in the lung, 1 had carcinoid of the lung and 1 had retroperitoneal neurofibroma. Thus, there was a 7 per cent incidence of a mass being other than scar, teratoma or residual tumor. There was 1 operative death and 10 deaths of tumor, for an 18 per cent death rate. Of the 17 patients with active tumor 9 responded to salvage chemotherapy with stable complete remission and a minimum followup of 18 months. In addition to the 60 patients the advanced disease in 10 was surgically debulked after failure of chemotherapy and this procedure was followed by salvage chemotherapy. All 10 patients died, with a median survival of 7 months. The lack of responsiveness to chemotherapy was not improved by incomplete removal of tumor. © 1983 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited ByLotherington Qvist H, Fosså S, Ous S, Høie J, Stenwig A and Giercksky K (2018) Post-Chemotherapy Tumor Residuals in Patients with Advanced Nonseminomatous Testicular Cancer. Is it Necessary to Resect All Residual Masses?Journal of Urology, VOL. 145, NO. 2, (300-302), Online publication date: 1-Feb-1991.Freiha F, Shortliffe L, Rouse R, Mark J, Hannigan J, Aston D, Spaulding J, Williams R and Torti F (2018) The Extent of Surgery after Chemotherapy for Advanced Germ Cell TumorsJournal of Urology, VOL. 132, NO. 5, (915-917), Online publication date: 1-Nov-1984.Pontes J, Wajsman Z and Huben R (2018) The Treatment of Poor Risk Nonseminomatous Testicular TumorsJournal of Urology, VOL. 131, NO. 3, (494-496), Online publication date: 1-Mar-1984.Kamer M, Rowland R, Einhorn L and Donohue J (2018) Recurrent Testis Cancer: Seeding from Retroperitoneal Nodes after Complete Remissions by ChemotherapyJournal of Urology, VOL. 130, NO. 6, (1196-1198), Online publication date: 1-Dec-1983. Volume 129Issue 1January 1983Page: 39-43 Advertisement Copyright & Permissions© 1983 by The American Urological Association Education and Research, Inc.MetricsAuthor Information R. Bruce Bracken More articles by this author Douglas E. Johnson More articles by this author O. Howard Frazier More articles by this author Christopher J. Logothetis More articles by this author Antonio Trindade More articles by this author Melvin L. Samuels More articles by this author Expand All Advertisement PDF DownloadLoading ...