Recurrence in nonseminomatous germ cell testis tumor patients with no viable tumor at postchemotherapy retroperitoneal lymph node dissection.
Urology
; 70(6): 1173-8, 2007 Dec.
Article
en En
| MEDLINE
| ID: mdl-18158041
ABSTRACT
OBJECTIVES:
To determine disease-related outcomes in metastatic testis cancer patients with absence of viable cancer in the postchemotherapy retroperitoneal lymph node dissection (PC-RPLND) specimen and determine whether clinical variables can help predict disease progression.METHODS:
Between 1980 and 2003, 195 patients had no viable tumor at the time of PC-RPLND. We retrospectively reviewed their medical records for pertinent clinical and treatment-related outcomes. At a median follow-up of 45 months (range, 6 to 236 months), 35 patients (18%) developed recurrences, and 18 (9%) died of disease.RESULTS:
On multivariate analysis, predictors of recurrence-free survival in patients with no viable tumor were advanced clinical stage (P = 0.01) and poor-risk International Germ Cell Consensus Classification (IGCCC) group (P = 0.01), whereas predictors of disease-specific survival included an elevated serum beta-human chorionic gonadotropin (hCG) level before PC-RPLND (P = 0.002), pathologic diameter of the retroperitoneal mass (P = 0.05), and postoperative recurrence (P <0.0001). An hCG level greater than 1.2 mIU/mL before PC-RPLND trended toward statistical significance (P = 0.07), and pathologic diameter of the retroperitoneal mass greater than 2.5 cm was statistically significant (P = 0.05) in predicting a poorer disease-specific survival.CONCLUSIONS:
Patients with no viable tumor at PC-RPLND remain at risk of recurrence. Several clinical variables, including advanced clinical stage, poor-risk IGCCC group, preoperative serum hCG level, diameter of the retroperitoneal mass on pathology, and postoperative recurrence, help better define which patients are at risk.
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Banco de datos:
MEDLINE
Asunto principal:
Neoplasias Testiculares
/
Protocolos de Quimioterapia Combinada Antineoplásica
/
Neoplasias de Células Germinales y Embrionarias
/
Escisión del Ganglio Linfático
Tipo de estudio:
Prognostic_studies
Límite:
Adolescent
/
Adult
/
Humans
/
Male
/
Middle aged
Idioma:
En
Año:
2007
Tipo del documento:
Article