Simultaneous retroperitoneal, thoracic, and cervical resection of postchemotherapy residual masses in patients with metastatic nonseminomatous germ cell tumors of the testis Journal Article


Authors: Brenner, P. C.; Herr, H. W.; Morse, M. J.; Sheinfeld, J.; Aprikian, A.; Bosl, G. J.; Motzer, R. J.; Bajorin, D. F.; Schantz, S.; Fair, W. R.; Burt, M.
Article Title: Simultaneous retroperitoneal, thoracic, and cervical resection of postchemotherapy residual masses in patients with metastatic nonseminomatous germ cell tumors of the testis
Abstract: Purpose: We report our experience with simultaneous resection of residual masses above and below the diaphragm in patients with metastatic nomseminomatous germ cell tumor (NSGCT) of the testis. Materials and Methods: Twenty-four patients underwent simultaneous resection of residual postchemotherapy masses in the retroperitoneum and chest, including three who also had radical neck dissection. All had been heavily pretreated with chemotherapy and five had undergone previous retroperitoneal lymph node dissections (RPLNDs). Results: The combined procedure was performed with no mortality and low morbidity. The median length of the procedure was 5 hours 45 minutes, median blood loss 500 mL, and median length of hospital stay 9 days. Complications included one patient with chylous ascites and one with a prolonged air leak, both of which resolved with conservative management. Eighteen patients had similar pathologic findings in all sites: 13 with necrosis only and five with teratoma only. Six patients had discordant pathology in the abdomen and chest, including one with viable tumor in the chest only and two with viable tumor in the abdomen only. The overall actuarial 5-year survival rate for all patients was 79%. Conclusion: Simultaneous resection of neck, chest, and abdominal residual masses after chemotherapy for germ cell tumors is both a feasible and safe alternative to staged excision in selected patients who require surgical intervention at multiple situs and fulfills the objective of rendering patients disease-free in a single operative procedure.
Keywords: adolescent; adult; cancer survival; clinical article; human tissue; treatment outcome; middle aged; survival rate; human cell; neck dissection; cisplatin; doxorubicin; combined modality therapy; paraaortic lymph node; lymph node excision; etoposide; vincristine; ifosfamide; postoperative complications; thoracic neoplasms; neoplasm, residual; head and neck neoplasms; testicular neoplasms; bleomycin; retroperitoneal neoplasms; orchiectomy; recombinant granulocyte colony stimulating factor; germ cell tumor; non seminomatous germinoma; chylous ascites; germinoma; humans; human; male; priority journal; article
Journal Title: Journal of Clinical Oncology
Volume: 14
Issue: 6
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 1996-06-01
Start Page: 1765
End Page: 1769
Language: English
PUBMED: 8656244
PROVIDER: scopus
DOI: 10.1200/JCO.1996.14.6.1765
DOI/URL:
Notes: Article -- Export Date: 22 November 2017 -- Source: Scopus
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MSK Authors
  1. Dean Bajorin
    416 Bajorin
  2. Robert Motzer
    769 Motzer
  3. Stimson P Schantz
    96 Schantz
  4. Joel Sheinfeld
    197 Sheinfeld
  5. Harry W Herr
    407 Herr
  6. George Bosl
    270 Bosl
  7. William R Fair
    199 Fair
  8. Michael E. Burt
    145 Burt