The role of thoracotomy in managing postchemotherapy residual thoracic masses in patients with nonseminomatous germ cell tumours Journal Article
| Authors: | Mcguire, M. S.; Rabbani, F.; Mohseni, H.; Bains, M.; Motzer, R.; Sheinfeld, J. |
| Article Title: | The role of thoracotomy in managing postchemotherapy residual thoracic masses in patients with nonseminomatous germ cell tumours |
| Abstract: | OBJECTIVE: To evaluate the clinical outcome and identify prognostic variables in patients with nonseminomatous germ cell tumours undergoing postchemotherapy thoracotomy for residual masses, as the role of this procedure is controversial. PATIENTS AND METHODS: Of 385 patients who underwent postchemotherapy retroperitoneal lymph node dissections between 1988 and 1998, 105 also had 130 thoracotomies. The clinical presentation, chemotherapy regimens, marker status, primary tumour histology, pathology of all resected masses, and clinical outcome of these 105 patients were analysed. RESULTS: The overall discordance rate for synchronous thoracic and retroperitoneal masses was 28%; that for asynchronous thoracic and retroperitoneal masses was 57%. Independent prognostic factors for residual thoracic teratoma or cancer were teratoma (mature or immature) in the primary tumour or retroperitoneal teratoma or cancer. Although three of 12 patients with residual thoracic cancer remained with no evidence of disease, residual thoracic cancer is an independent prognostic factor (P < 0.001) against disease-free survival. CONCLUSION: Postchemotherapy thoracotomy yields important prognostic information, and is therapeutic for most patients with teratoma and a subset with residual viable cancer. The prognostic criteria predictive of fibrosis are not sufficiently accurate to omit resection of residual thoracic masses. |
| Keywords: | cancer chemotherapy; treatment outcome; disease-free survival; major clinical study; cancer localization; cancer recurrence; cancer risk; cancer patient; follow-up studies; disease association; carboplatin; etoposide; thoracotomy; antineoplastic combined chemotherapy protocols; odds ratio; obesity; tumor biopsy; oncology; ifosfamide; vinblastine; risk assessment; prostate cancer; thoracic neoplasms; evaluation; prostatectomy; testicular neoplasms; bleomycin; outcomes research; platinum; testis cancer; germ cell tumor; thorax tumor; non seminomatous germinoma; germinoma; humans; prognosis; human; male; priority journal; article; nonseminomatous germ cell cancer |
| Journal Title: | BJU International |
| Volume: | 91 |
| Issue: | 6 |
| ISSN: | 1464-4096 |
| Publisher: | Wiley Blackwell |
| Date Published: | 2003-04-01 |
| Start Page: | 469 |
| End Page: | 473 |
| Language: | English |
| DOI: | 10.1046/j.1464-410X.2003.04128.x |
| PUBMED: | 12656895 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Export Date: 12 September 2014 -- Source: Scopus |
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