Clinical outcome of robot-assisted residual mass resection in metastatic nonseminomatous germ cell tumor
| Autor: | Axel Bex, Henk G. van der Poel, Simon Horenblas, Oscar R. Brouwer, J. Martijn Kerst, J.L.H. Ruud Bosch, Richard P. Meijer, Joost M. Blok |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Neoplasm Residual Urologic Surgical Procedures Male Urology medicine.medical_treatment 030232 urology & nephrology Testicular Germ Cell Tumor Nonseminomatous germ cell tumor Retroperitoneal lymph node dissection 03 medical and health sciences Young Adult 0302 clinical medicine Testicular cancer Robotic Surgical Procedures Testicular Neoplasms Interquartile range Medicine Humans Neoplasm Metastasis Survival rate Retrospective Studies Chemotherapy business.industry Robotic surgery Neoplasms Germ Cell and Embryonal medicine.disease Treatment Outcome 030220 oncology & carcinogenesis Inclusion and exclusion criteria Testicular germ cell tumor Original Article Radiology Teratoma Robot-assisted retroperitoneal lymph node dissection business |
| Zdroj: | World Journal of Urology |
| ISSN: | 1433-8726 0724-4983 |
| Popis: | Purpose To evaluate the outcome of robot-assisted residual mass resection (RA-RMR) in nonseminomatous germ cell tumor (NSGCT) patients with residual tumor following chemotherapy. Patients and methods Retrospective medical chart analysis of all patients with NSGCT undergoing RA-RMR at two tertiary referral centers between January 2007 and April 2019. Patients were considered for RA-RMR in case of a residual tumor between 10 and 50 mm at cross-sectional computed tomography (CT) imaging located ventrally or laterally from the aorta or vena cava, with normalized tumor markers following completion of chemotherapy, and no history of retroperitoneal surgery. Results A total of 45 patients were included in the analysis. The Royal Marsden stage before chemotherapy was IIA in 13 (28.9%), IIB in 16 (35.6%), IIC in 3 (6.7%) and IV in 13 patients (28.9%). The median residual tumor size was 1.9 cm (interquartile range [IQR] 1.4–2.8; range 1.0–5.0). Five procedures (11.1%) were converted to an open procedure due to a vascular injury (n = 2), technical difficulty (n = 2) or tumor debris leakage (n = 1). A postoperative adverse event occurred in two patients (4.4%). Histopathology showed teratoma, necrosis and viable cancer in 29 (64.4%), 14 (31.1%), and two patients (4.4%), respectively. After a median follow-up of 41 months (IQR 22–70), one patient (2.2%) relapsed in the retroperitoneum. The one- and 2-year recurrence-free survival rate was 98%. Conclusion RA-RMR is an appropriate treatment option in selected patients, potentially providing excellent cure rates with minimal morbidity. Long-term outcome data are needed to further support this strategy and determine inclusion and exclusion criteria. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink