Surgical resection of solitary metastases after chemotherapy in patients with nonseminomatous germ cell tumors and elevated serum tumor markers Journal Article
| Authors: | Wood, D. P. Jr; Herr, H. W.; Motzer, R. J.; Reuter, V.; Sogani, P. C.; Morse, M. J.; Bosl, G. J. |
| Article Title: | Surgical resection of solitary metastases after chemotherapy in patients with nonseminomatous germ cell tumors and elevated serum tumor markers |
| Abstract: | Background. Chemorefractory metastatic germ cell tumors and elevated tumor markers generally indicate inoperable disease. Methods. Solitary metastases were resected in 15 patients who had a nonseminomatous germ cell tumor and an elevated alpha‐fetoprotein (AFP) and/or human chorionic gonadotropin (HCG) serum level after treatment with cisplatin‐based chemotherapy. Patients underwent resection for a residual mass after chemotherapy or for a new solitary metastasis after achieving a complete response (CR) to salvage chemotherapy. Results. Seven patients were disease‐free after surgical resection alone. All five patients with an elevated HCG level had a relapse after surgery compared with 3 of 10 patients with only an elevated AFP level. Only 4 of 10 patients with a retroperitoneal metastasis had a relapse after surgery compared with 4 of 5 patients with visceral disease. Eleven of 15 patients overall were disease‐free after surgery and subsequent chemotherapy after a relapse. Conclusions. Surgical resection of a solitary metastasis despite elevated serum tumor markers should be considered in patients who have not had a durable CR to cisplatin‐based chemotherapy. Cancer 1992; 702354‐2357. Copyright © 1992 American Cancer Society |
| Keywords: | clinical article; human tissue; cancer surgery; survival rate; cancer recurrence; salvage therapy; cisplatin; cancer combination chemotherapy; bone metastasis; chemotherapy, adjuvant; lymphatic metastasis; metastasis; neoplasm recurrence, local; etoposide; antineoplastic combined chemotherapy protocols; tumor markers, biological; cyclophosphamide; ifosfamide; vinblastine; lung metastasis; cancer regression; drug response; testis tumor; dactinomycin; remission induction; bleomycin; surgical resection; neoplasms, germ cell and embryonal; retroperitoneal neoplasms; mediastinum tumor; germ cell tumors; non seminomatous germinoma; retroperitoneal cancer; metastatic; alpha fetoprotein; chorionic gonadotropin; mediastinum metastasis; autologous bone marrow transplantation; alpha-fetoproteins; prognosis; human; priority journal; article; elevated tumor markers |
| Journal Title: | Cancer |
| Volume: | 70 |
| Issue: | 9 |
| ISSN: | 0008-543X |
| Publisher: | Wiley Blackwell |
| Date Published: | 1992-11-01 |
| Start Page: | 2354 |
| End Page: | 2357 |
| Language: | English |
| DOI: | 10.1002/1097-0142(19921101)70:9<2354::Aid-cncr2820700924>3.0.Co;2-u |
| PUBMED: | 1382832 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Export Date: 30 July 2019 -- Source: Scopus |
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