Residual masses after chemotherapy for metastatic testicular cancer: the clinical implications of the association between retroperitoneal and pulmonary histology
| Autor: | J.P. Donohue, G.C. Toner, Sophie D. Fosså, A. Gerl, Ewout W. Steyerberg, H. Schraffordt Koops, H.J. Keizer |
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| Přispěvatelé: | Public Health |
| Rok vydání: | 1997 |
| Předmět: |
Pathology
medicine.medical_specialty RESECTION medicine.medical_treatment Urology Metastasis NODE DISSECTION surgery Retroperitoneal lymph node dissection SDG 3 - Good Health and Well-being PROGNOSTIC FACTORS Medicine Lymph node MULTIVARIATE-ANALYSIS Testicular cancer business.industry thoracic neoplasms Induction chemotherapy testicular neoplasms GERM-CELL TUMORS medicine.disease Primary tumor abdominal neoplasms medicine.anatomical_structure pathology Teratoma Germ cell tumors business |
| Zdroj: | Journal of Urology, 158, 474-478. Elsevier Inc. Journal of Urology, 158(2), 474-478. LIPPINCOTT WILLIAMS & WILKINS |
| ISSN: | 0022-5347 |
| Popis: | Purpose: We determined the need and sequence of retroperitoneal lymph node dissection and thoracotomy in patients with nonseminomatous testicular cancer, and with residual retroperitoneal and pulmonary masses after chemotherapy. Materials and Methods: We studied 159 patients undergoing retroperitoneal lymph node dissection and a thoracotomy following cisplatin based induction chemotherapy for metastatic testicular nonseminomatous germ cell tumor. Several well-known predictors for residual histology (necrosis, mature teratoma and cancer) were evaluated. Results: As expected, necrosis was found more often at retroperitoneal lymph node dissection if the primary tumor was negative for teratoma, the residual mass was small or the decrease in size was great. Contrary, neither residual mass size nor the decrease in size was predictive of the histological status of the residual lung lesion. Histological findings in the retroperitoneum and lung were strongly correlated, such that necrosis at retroperitoneal lymph node dissection was associated with an 89% probability of necrosis in the lung. Conclusions: Retroperitoneal lymph node dissection should be performed before thoracotomy is considered, since the histological status at dissection is a strong predictor of that at thoracotomy. |
| Databáze: | OpenAIRE |
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