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Histology of Tumor Residuals Following Chemotherapy in Patients with Advanced Nonseminomatous Testicular Cancer

1989; Lippincott Williams & Wilkins; Volume: 142; Issue: 5 Linguagem: Inglês

10.1016/s0022-5347(17)39044-4

1527-3792

Sophie D. Fosså, Nina Aass, Sigurd Ous, J Høie, Anna E. Stenwig, Hans H. Lien, Elisabeth Paus, Olav Kaalhus,

Sexual Differentiation and Disorders

No AccessJournal of Urology1 Nov 1989Histology of Tumor Residuals Following Chemotherapy in Patients with Advanced Nonseminomatous Testicular Canceris companion ofEditorial CommentsEditorial Comments Sophie D. FossÅ, Nina Aass, Sigurd Ous, Johan Høie, Anna E. Stenwig, Hans H. Lien, Elisabeth Paus, and Olav Kaalhus Sophie D. FossÅSophie D. FossÅ , Nina AassNina Aass , Sigurd OusSigurd Ous , Johan HøieJohan Høie , Anna E. StenwigAnna E. Stenwig , Hans H. LienHans H. Lien , Elisabeth PausElisabeth Paus , and Olav KaalhusOlav Kaalhus View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)39044-4AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail A total of 111 patients with advanced nonseminomatous testicular cancer underwent cisplatin-based combination chemotherapy, followed by surgical removal of residual masses in 101. Surgery included retroperitoneal lymph node dissection in 92 patients, thoracotomy in 19 and hepatic resection in 1 (11 patients underwent 2 operations). Complete necrosis and/or fibrosis was found in 52 operative specimens, mature teratoma in 37 and vital malignant tumor in 12. Of the 11 patients who underwent 2 operations 4 had complete necrosis and/or fibrosis in both histological specimens. After a median observation of 55 months 83 of 89 patients with complete necrosis and/or fibrosis or mature teratoma were without evidence of disease. Only 7 of 12 patients with vital malignant tumor in the operative specimen survived without evidence of disease. Relapses were observed in 16 patients, 4 of them in the retroperitoneal space. Of the 16 relapses 5 were in 12 patients with residual vital malignant tumor, 5 in 37 patients with post-chemotherapy mature teratoma and 4 in 52 patients with complete necrosis and/or fibrosis after chemotherapy. Two patients with recurrence did not undergo an operation. In patients in whom post-chemotherapy retroperitoneal lymph node dissection is considered complete necrosis and/or fibrosis can be predicted by the combination of several factors, including absence of teratomatous elements in the testicular tumor, complete response on post-chemotherapy computerized tomography, and normal α-fetoprotein and human chorionic gonadotropin levels after chemotherapy (sensitivity 83%, specificity 76% and correctly predicted 79%). With the knowledge of these factors it seems possible to omit post-chemotherapy retroperitoneal lymph node dissection in approximately 20% of the patients with advanced metastatic nonseminomatous testicular cancer with initial retroperitoneal tumors. (J. Urol., 142:1239-1242, 1989) © 1989 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byCalaway A, Kern S, Crook D, Tong Y, Masterson T, Adra N, Einhorn L, Foster R and Cary C (2021) Percentage of Teratoma in Orchiectomy and Risk of Retroperitoneal Teratoma at the Time of Postchemotherapy Retroperitoneal Lymph Node Dissection in Germ Cell TumorsJournal of Urology, VOL. 206, NO. 6, (1430-1437), Online publication date: 1-Dec-2021.Leão R, van Agthoven T, Figueiredo A, Jewett M, Fadaak K, Sweet J, Ahmad A, Anson-Cartwright L, Chung P, Hansen A, Warde P, Castelo-Branco P, O'Malley M, Bedard P, Looijenga L and Hamilton R (2018) Serum miRNA Predicts Viable Disease after Chemotherapy in Patients with Testicular Nonseminoma Germ Cell TumorJournal of Urology, VOL. 200, NO. 1, (126-135), Online publication date: 1-Jul-2018.Beck S, Foster R, Bihrle R, Einhorn L and Donohue J (2009) Long-Term Outcome for Patients With High Volume Retroperitoneal Teratoma Undergoing Post-Chemotherapy SurgeryJournal of Urology, VOL. 181, NO. 6, (2526-2532), Online publication date: 1-Jun-2009.DeWolf W (2018) Editorial CommentJournal of Urology, VOL. 176, NO. 1, (103-103), Online publication date: 1-Jul-2006.Beck S, Foster R, Bihrle R, Ulbright T, Koch M, Wahle G, Einhorn L and Donohue J (2018) Teratoma in the Orchiectomy Specimen and Volume of Metastasis are Predictors of Retroperitoneal Teratoma in Post-Chemotherapy Nonseminomatous Testis CancerJournal of Urology, VOL. 168, NO. 4 Part 1, (1402-1404), Online publication date: 1-Oct-2002.JANETSCHEK G, HOBISCH A, HITTMAIR A, HOLTL L, PESCHEL R and BARTSCH G (2018) LAPAROSCOPIC RETROPERITONEAL LYMPHADENECTOMY AFTER CHEMOTHERAPY FOR STAGE IIB NONSEMINOMATOUS TESTICULAR CARCINOMAJournal of Urology, VOL. 161, NO. 2, (477-481), Online publication date: 1-Feb-1999.PISTERS L, DINNEY C, PETTAWAY C, SCOTT S, BABAIAN R, von ESCHENBACH A and TRONCOSO P (2018) A FEASIBILITY STUDY OF CRYOTHERAPY FOLLOWED BY RADICAL PROSTATECTOMY FOR LOCALLY ADVANCED PROSTATE CANCERJournal of Urology, VOL. 161, NO. 2, (509-514), Online publication date: 1-Feb-1999.Steyerberg E, Donohue J, Gerl A, Toner G, Koops H, Fossa S and Keizer H (2018) Residual Masses After Chemotherapy for Metastatic Testicular Cancer: The Clinical Implications of the Association between Retroperitoneal and Pulmonary HistologyJournal of Urology, VOL. 158, NO. 2, (474-478), Online publication date: 1-Aug-1997.Weissbach L and Hartlapp J (2018) Adjuvant Chemotherapy of Metastatic Stage II Nonseminomatous Testis TumorJournal of Urology, VOL. 146, NO. 5, (1295-1298), Online publication date: 1-Nov-1991.Lotherington 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.Richie J (2018) Editorial CommentsJournal of Urology, VOL. 145, NO. 2, (302-303), Online publication date: 1-Feb-1991.Related articlesJournal of Urology13 Nov 2018Editorial CommentsJournal of Urology13 Nov 2018Editorial Comments Volume 142Issue 5November 1989Page: 1239-1242 Advertisement Copyright & Permissions© 1989 by The American Urological Association Education and Research, Inc.MetricsAuthor Information Sophie D. FossÅ More articles by this author Nina Aass More articles by this author Sigurd Ous More articles by this author Johan Høie More articles by this author Anna E. Stenwig More articles by this author Hans H. Lien More articles by this author Elisabeth Paus More articles by this author Olav Kaalhus More articles by this author Expand All Advertisement PDF downloadLoading ...