Does lymphangiography have any role in the management of early non-seminomatous germ cell tumours?
Since 1980, 51 patients with non-seminomatous testicular germ cell tumours (NSGCT) and normal or equivocal initial computed tomography (CT) imaging have also had lymphography performed. Radiological records of these patients were reviewed to determine the extent to which lymphography (LAG) contributed to patient management. Forty-nine patients were retrospectively confirmed to have normal CT but of these 14 (29%) were considered to have nodal metastatic disease on lymphography. These patients and seven others with marker only evidence of tumour received chemotherapy and all remain disease-free. Six of thirty-six patients relapsed, but the incidence was not significantly higher in patients who did not undergo LAG (2 of 8:25%) than among those whose initial LAG was normal (4 of 28: 14%). All relapsing tumours achieved a complete remission with chemotherapy. We conclude that although LAG may have resulted in earlier treatment for some patients, several may have been overtreated on the basis of radiological abnormalities which did not represent metastatic disease. We believe that the success of salvage chemotherapy means that LAG may be safely abandoned as a staging procedure for NSGCT.
Harding
M
M
CRC Department of Medical Oncology, University of Glasgow.
Dall
B
B
Corbett
R
R
Vallance
R
R
Kaye
S B
SB
D006801:Humans; D008220:Lymphography; D008297:Male; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D012189:Retrospective Studies; D013724:Teratoma / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology; D013736:Testicular Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology; D014057:Tomography, X-Ray Computed