Reassessment of the Role of Adjunctive Surgical Therapy in the Treatment of Advanced Germ Cell Tumors

No AccessJournal of Urology1 Dec 1987Reassessment of the Role of Adjunctive Surgical Therapy in the Treatment of Advanced Germ Cell Tumors Gregory E. Carter, Gary Lieskovsky, Donald G. Skinner, and John R. Daniels Gregory E. CarterGregory E. Carter More articles by this author , Gary LieskovskyGary Lieskovsky More articles by this author , Donald G. SkinnerDonald G. Skinner More articles by this author , and John R. DanielsJohn R. Daniels More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)43654-8AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail We treated 30 patients for stage B3 or B3C germ cell tumors between December 1978 and December 1983. After initial, high dose, platinum-based combination chemotherapy, all patients underwent adjunctive resection of all clinically evident residual disease. Residual malignant elements were found in the retroperitoneum in 35 per cent of 26 nonseminomatous germ cell tumor patients and in 40 per cent of those with residual lesions beyond the retroperitoneum following chemotherapy. After additional chemotherapy, including platinum plus etoposide for patients with residual malignant elements, 80 and 75 per cent of those with stages B3 and B3C disease, respectively, achieved a complete sustained remission at a mean followup of 30 to 38 months, respectively. The strongest predictors of ultimate treatment failure were the presence of extensive pulmonary disease at presentation and the finding of residual malignant elements in resected lesions. Of 4 patients with seminoma 3 achieved sustained complete remission, while 1 died of recurrent embryonal carcinoma. These data support the role of adjunctive resection of clinically evident residual lesions following initial platinum-based chemotherapy in advanced metastatic germ cell tumors, and demonstrate the efficacy of additional platinum-etoposide-based chemotherapy in the 35 to 40 per cent of patients who harbor residual malignant disease in resected lesions. © 1987 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited ByBECK S, FOSTER R, BIHRLE R, KOCH M, WAHLE G and DONOHUE J (2018) AORTIC REPLACEMENT DURING POST-CHEMOTHERAPY RETROPERITONEAL LYMPH NODE DISSECTIONJournal of Urology, VOL. 165, NO. 5, (1517-1520), Online publication date: 1-May-2001.Rasmussen O, Daugaard G, Christiansen S, Sørensen B and Rørth M (2018) Secondary Surgery in Patients with Malignant Germ Cell TumorsJournal of Urology, VOL. 147, NO. 2, (393-397), Online publication date: 1-Feb-1992.Donohue J, Thornhill J, Foster R, Rowland R and Bihrle R (2018) Resection of the Inferior Vena Cava or Intraluminal Vena Caval Tumor Thrombectomy During Retroperitoneal Lymph Node Dissection for Metastatic Germ Cell Cancer: Indications and ResultsJournal of Urology, VOL. 146, NO. 2 Part 1, (346-349), Online publication date: 1-Aug-1991.FossÅ S, Aass N, Ous S, Høie J, Stenwig A, Lien H, Paus E and Kaalhus O (2018) Histology of Tumor Residuals Following Chemotherapy in Patients with Advanced Nonseminomatous Testicular CancerJournal of Urology, VOL. 142, NO. 5, (1239-1242), Online publication date: 1-Nov-1989. Volume 138Issue 6December 1987Page: 1397-1401 Advertisement Copyright & Permissions© 1987 by The American Urological Association Education and Research, Inc.MetricsAuthor Information Gregory E. Carter More articles by this author Gary Lieskovsky More articles by this author Donald G. Skinner More articles by this author John R. Daniels More articles by this author Expand All Advertisement PDF DownloadLoading ...