Simultaneous Vs Sequential Retroperitoneal, Thoracic and Cervical Resection of Post Chemotherapy Residual Masses in Patients With Metastatic Nonseminomatous Germ Cell Tumors of the Testis - 04/04/20
Abstract |
Objective |
To compare a simultaneous vs sequential approach to residual post chemotherapy mass resections in metastatic testis cancer.
Methods |
A retrospective review was performed of patients who underwent retroperitoneal and thoracic/cervical resection of post chemotherapy residual masses between 2002 and 2018. Group 1: “Simultaneous” (Combined Retroperitoneal and Thoracic/Cervical resections on the same date); Group 2: “Sequential” (Retroperitoneal and Thoracic/Cervical resections at separate dates).
Results |
During the study period, 35 simultaneous and 17 sequential resections were performed. The median age at surgery was 28 years (Range 16-61). The median follow-up from last surgical procedure was 62.7 months (Range 0.4-194). Histology revealed teratoma in 38 (73.1%) patients, necrosis in 8 (15.4%) and viable tumor in 6 (11.5%). Discordant pathology findings between thoracic/cervical and abdominal resections were noted in 16 (30.8%) patients.
No differences were observed between the simultaneous vs sequential groups in median operating time (585 minutes vs 545 minutes, P = .64), blood loss (1300 vs 1300 mls, P = .42), or length of stay (9 vs 11 days, P = .14). There was no difference between the 5-year (65.7% vs 68.6%) relapse-free survival between the 2 groups (P = .84) or the 5-year (88.6% vs 100%) overall and disease-specific survival (P = .25).
Conclusion |
Simultaneous resection of retroperitoneal and thoracic/cervical post chemotherapy metastases is a feasible in some patients. It requires multidisciplinary collaboration and a longer primary procedure.
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| Funding: None. |
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| Conflicts of Interest: Gregory Nason, Laura Donahoe, Ishan Aditya, Marc de Perrot, Michael Jewett, Padraig Warde, Peter Chung, Lynn Anson-Cartwright, Aaron Hansen, Philip Bedard, Martin O'Malley, Joan Sweet, Eshetu Atenafu—None. Robert Hamilton—Advisory Board—Bayer, Amgen, Janssen, Astellas; Research Funding—Bayer (ARASENS trial), Janssen (SPARTAN trial); Speaking Honoraria—Abbvie; Meeting Travel—Roche. |
Vol 138
P. 69-76 - avril 2020 Retour au numéro
Article précédent
- Risk Factors for Upstaging, Recurrence, and Mortality in Clinical T1-2 Renal Cell Carcinoma Patients Upstaged to pT3a Disease: An International Analysis Utilizing the 8th Edition of the Tumor-Node-Metastasis Staging Criteria
- Zachary A. Hamilton, Umberto Capitanio, Deepak Pruthi, Fady Ghali, Alessandro Larcher, Devin N. Patel, Ahmed Eldefrawy, Sunil Patel, Brittney H. Cotta, Aaron W. Bradshaw, Margaret F. Meagher, Nathan S. Miller, Cristina Carenzi, Fang Wan, Michael A. Liss, Thomas McGregor, Francesco Montorsi, Ithaar H. Derweesh
- EDITORIAL COMMENT
- Maria F. Becerra, Richard S. Matulewicz, Joel Sheinfeld
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