Clinical outcome after retroperitoneal lymphadenectomy of patients with pure testicular teratoma Journal Article


Authors: Rabbani, F.; Farivar-Mohseni, H.; Leon, A.; Motzer, R. J.; Bosl, G. J.; Sheinfeld, J.
Article Title: Clinical outcome after retroperitoneal lymphadenectomy of patients with pure testicular teratoma
Abstract: Objectives. To determine the pathologic findings and clinical outcome of patients with pure teratoma of the testis who underwent primary or postchemotherapy retroperitoneal lymphadenectomy (RPLND). Methods. From January 1989 to February 1998, 29 patients with pure testicular teratoma underwent primary (n = 11) or postchemotherapy (n = 18) RPLND. Results. Overall, 23 (79%) of 29 patients had retroperitoneal disease, with 18 (62%) initially presenting with advanced disease. The pathologic stage in the 11 patients undergoing primary RPLND was pN0 in 6 (55%), pN1 in 3 (27%), and pN2 in 2 (18%). Of the 7 patients with clinical Stage I undergoing primary RPLND, 1 had teratoma and 1 had seminoma in the retroperitoneum; of the 4 patients with clinical Stage IIA, 2 had teratoma and 1 had embryonal carcinoma. Four patients were lost to follow-up and the other seven had no evidence of disease (NED) at a median follow-up of 90.4 months, with no relapses. The pathologic findings in the 18 patients undergoing postchemotherapy RPLND revealed fibrosis in 8, teratoma in 9, and yolk sac tumor in 1. At last follow-up, 7 of the 9 patients with teratoma were NED, 1 was dead of disease, and 1 was dead of unknown causes. Of the 8 patients with fibrosis, 6 had NED and 2 were lost to follow-up. The patient with viable cancer had NED at last follow-up. Conclusions. These data underscore the metastatic potential of pure testicular teratoma. A significant proportion (45%) of patients with low-stage pure testicular teratoma had retroperitoneal disease. Furthermore, a high proportion (62%) presented initially with advanced disease and demonstrated a considerable risk of relapse despite complete resection or favorable histologic features in the resected retroperitoneal specimen. © 2003 Elsevier Inc.
Keywords: adolescent; adult; clinical article; controlled study; human tissue; treatment outcome; cancer recurrence; combined modality therapy; cancer staging; follow up; follow-up studies; paraaortic lymph node; lymphatic metastasis; neoplasm staging; lymph node excision; prospective studies; lymphadenectomy; metastasis; cohort studies; antineoplastic combined chemotherapy protocols; pathology; histology; fibrosis; liver metastasis; lung metastasis; testicular neoplasms; teratoma; retroperitoneal tumor; seminoma; yolk sac tumor; retroperitoneal space; testis teratoma; carcinoma, embryonal; retroperitoneal fibrosis; humans; human; male; priority journal; article
Journal Title: Urology
Volume: 62
Issue: 6
ISSN: 0090-4295
Publisher: Elsevier Science, Inc.  
Date Published: 2003-12-01
Start Page: 1092
End Page: 1096
Language: English
DOI: 10.1016/s0090-4295(03)00770-2
PUBMED: 14665362
PROVIDER: scopus
DOI/URL:
Notes: Export Date: 12 September 2014 -- Source: Scopus
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MSK Authors
  1. Robert Motzer
    1243 Motzer
  2. Farhang Rabbani
    84 Rabbani
  3. Joel Sheinfeld
    254 Sheinfeld
  4. George Bosl
    430 Bosl