Resection of retroperitoneal residual mass after chemotherapy in patients with nonseminomatous testicular cancer

Ahmet ÖZET,Ali Aydın YAVZU,MEHMET MURAT BEYZADEOĞLU,Yaşar ÖZGÖK,Bekir ÖZTÜRK,Fikret ARPACI,Şeref KÖMÜRCÜ,Levent YAMANEL,Teoman DOĞRU

Abstract

Retroperitoneal lymph node dissection followed by chemotherapy for the treatment of nonseminomatous testis cancer is reserved for partial remissions. One hundred and sixty seven patients with nonseminomatous testis cancer were admitted to Gülhane Military Medical Academy between the years of 1992-1999. Retroperitoneal residual masses determined radiologically were resected in 12 patients (9 teratocarcinoma, 3 embryonal carcinoma) with stage-B after cisplatin-based therapy (PVB in 8 and PEB in 4 patients). Alpha-fetoprotein (AFP) and beta subunit of human chorionic gonadotropin (p-HCG) levels in all patients were normal before resection. The pathologic evaluation of removed retroperitoneal masses showed residual malignancy in 6 patients, mature teratoma in 5 patients and necrosis in 1 patient. Patients with malignant residual tumour (n=6) received chemotherapy, and the others (n=6) were followed by surveillance only. Our data presented herein imply that surgical removal of all post-chemotherapy residual masses is required before suggesting routine salvage chemotherapy.

Özet

Keywords: Lenf düğümü çıkartılması,Retroperitoneal neoplazmlar,Testis neoplazmları,Karsinom, embriyonal,Teratokarsinom,İlaç tedavisi