Predicting teratoma in the retroperitoneum in men undergoing post-chemotherapy retroperitoneal lymph node dissection Journal Article

  

Authors:	Carver, B. S.; Bianco, F. J. Jr; Shayegan, B.; Vickers, A.; Motzer, R. J.; Bosl, G. J.; Sheinfeld, J.
Article Title:	Predicting teratoma in the retroperitoneum in men undergoing post-chemotherapy retroperitoneal lymph node dissection
Abstract:	Purpose: The biological potential of teratoma remains unpredictable, therefore identifying its presence in the retroperitoneum remains important. We evaluated patients undergoing post-chemotherapy retroperitoneal lymph node dissection for nonseminomatous germ cell tumors to determine predictors of teratomatous elements in the retroperitoneum. Materials and Methods: We identified 532 patients from 1989 to 2003 who underwent retroperitoneal lymph node dissection following chemotherapy for nonseminomatous germ cell tumors at our institution. Multiple clinical and pathological variables were reviewed from our prospective retroperitoneal lymph node dissection database. A logistic regression model was designed based on preoperative variables to predict the presence of teratomatous elements in the retroperitoneal lymph node dissection specimen. Results: Of the 532 patients in our series 450 (85%) received only induction chemotherapy and 82 (15%) required salvage chemotherapy. Teratomatous elements were identified in the orchiectomy specimen in 42% of patients. Retroperitoneal nodal pathology revealed teratomatous elements in 235 (44%) patients and only teratoma in 210 (40%) patients. By multivariate analysis testicular yolk sac tumor (p = 0.046), teratoma in the orchiectomy specimen (p <0.005), relative change in nodal size before and after chemotherapy (p <0.005), and no requirement for salvage chemotherapy (p = 0.03) were independent predictors for the presence of teratoma in the retroperitoneum. Conclusions: Teratoma remains a common histological finding in the retroperitoneal lymph nodes following chemotherapy. We have identified several pre-retroperitoneal lymph node dissection variables that predict the finding of teratoma in the retroperitoneum for men treated with chemotherapy for metastatic nonseminomatous germ cell tumors. © 2006 American Urological Association.
Keywords:	cancer chemotherapy; controlled study; major clinical study; postoperative period; salvage therapy; antineoplastic agents; antineoplastic agent; lymph node dissection; lymphatic metastasis; lymph node excision; neoplasms; tumor volume; logistic models; data base; prediction; postoperative complication; testicular neoplasms; teratoma; multivariate analysis; orchiectomy; drug therapy; logistic regression analysis; germ cell tumor; yolk sac tumor; non seminomatous germinoma; retroperitoneum; retroperitoneal space; germ cell and embryonal
Journal Title:	Journal of Urology
Volume:	176
Issue:	1
ISSN:	0022-5347
Publisher:	Elsevier Science, Inc.
Date Published:	2006-07-01
Start Page:	100
End Page:	104
Language:	English
DOI:	10.1016/s0022-5347(06)00508-8
PUBMED:	16753380
PROVIDER:	scopus
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-33744546852&partnerID=40&md5=7d3fe6cd6319e715b844edb464986b34
Notes:	--- - "Cited By (since 1996): 22" - "Export Date: 4 June 2012" - "CODEN: JOURA" - "Source: Scopus"

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