Long-term clinical outcome after postchemotherapy retroperitoneal lymph node dissection in men with residual teratoma Journal Article
| Authors: | Carver, B. S.; Shayegan, B.; Serio, A.; Motzer, R. J.; Bosl, G. J.; Sheinfeld, J. |
| Article Title: | Long-term clinical outcome after postchemotherapy retroperitoneal lymph node dissection in men with residual teratoma |
| Abstract: | Purpose: The histologic finding of teratoma occurs in approximately 40% of all postchemotherapy retroperitoneal lymph node dissections (PC-RPLND). We evaluated patients at our institution undergoing initial PC-RPLND for teratoma to determine their clinical outcome. Patients and Methods: We identified 210 patients from 1989 to 2003 with nonseminomatous germ cell tumors (NSGCT) who underwent initial PC-RPLND and were found to have only teratoma in the retroperitoneum. Clinical and pathologic information was obtained from our prospective surgical database, and clinical outcome was reported. Results: Of the 210 patients in our series, 192 (92%) received only induction chemotherapy, and 18 (9%) required additional chemotherapy regimens. PC-RPLND pathology revealed mature teratoma in 178 patients (85%), immature teratoma in 15 patients (7%), and teratoma with malignant transformation in 17 patients (8%). With a median follow-up time for survivors of 37 months, disease recurred in 30 patients. The probability of remaining free of disease recurrence at 5 and 10 years was 83% and 80%, respectively. Of the 30 patients with disease recurrence, 10 (33%) had recurrence with teratoma, five (17%) had recurrence with teratoma with malignant transformation, and 15 (50%) had recurrence with viable germ cell tumor. On multivariable analysis, residual mass size and International Germ Cell Cancer Collaborative Group (IGCCCG) risk classification were predictors of disease recurrence (P < .0005 and = .001, respectively). Conclusion: PC-RPLND remains critical in the management of patients with NSGCT. Patients found to have teratoma at PC-RPLND have a 10-year probability of freedom from recurrence of 80%. The size of the residual mass and IGCCCG risk classification were significant predictors of disease recurrence. © 2007 by American Society of Clinical Oncology. |
| Keywords: | adult; cancer chemotherapy; cancer survival; controlled study; treatment outcome; disease-free survival; cancer surgery; major clinical study; histopathology; mortality; cancer recurrence; multimodality cancer therapy; antineoplastic agents; united states; disease free survival; combined modality therapy; cancer staging; follow up; follow-up studies; antineoplastic agent; lymph node dissection; lymph nodes; neoplasm staging; lymph node excision; lymphadenectomy; metastasis; tumor volume; proportional hazards models; pathology; time; time factors; risk assessment; kaplan-meiers estimate; register; registries; proportional hazards model; minimal residual disease; neoplasm, residual; lymph node; testis tumor; testicular neoplasms; prediction and forecasting; predictive value of tests; new york city; cancer relapse; teratoma; retroperitoneal tumor; retroperitoneal neoplasms; orchiectomy; kaplan meier method; tumor growth; cancer classification; non seminomatous germinoma; retroperitoneum; retroperitoneal space |
| Journal Title: | Journal of Clinical Oncology |
| Volume: | 25 |
| Issue: | 9 |
| ISSN: | 0732-183X |
| Publisher: | American Society of Clinical Oncology |
| Date Published: | 2007-03-20 |
| Start Page: | 1033 |
| End Page: | 1037 |
| Language: | English |
| DOI: | 10.1200/jco.2005.05.4791 |
| PUBMED: | 17261854 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 29" - "Export Date: 17 November 2011" - "CODEN: JCOND" - "Source: Scopus" |
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