title: [The diagnostic and therapeutic value of second look operation in patients with testicular germinal cell tumors (author's transl)].
abstract: We report on 32 patients with testicular tumor who--after earlier retroperitoneal lymph node dissection--underwent a second-look operation. Whereas in 16 patients vital tumor tissue was found in the retroperitoneum 9 patients had only degenerative changes with fibrosis and necrosis. In 7 patients the retroperitoneum showed no evidence of disease. It is our conclusion that an extensive pre-operative diagnostic workup, including tumor-markers, ultrasound and CT in patients treated with chemo- and radiotherapy cannot determine whether viable tumor tissue is present in the retroperitoneum. In 13 patients with non-seminomatous germinal cell tumors where viable tumor tissue was found at second-look operation 61,5% had normal tumor-markers. Those patients in whom at second-look operation no viable tumor tissue was found benefit from that approach because of the possibility of terminating aggressive chemotherapy. On the other hand patients with vital tumor tissue had a poor prognosis.
mesh_terms: D000293:Adolescent; D000328:Adult; D004407:Dysgerminoma / Q000556:secondary / Q000601:surgery*; D006801:Humans; D007984:Leydig Cell Tumor / Q000556:secondary / Q000601:surgery*; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D012187:Retroperitoneal Space; D013736:Testicular Neoplasms / Q000556:secondary / Q000601:surgery*
vernacular_title: Der diagnostische und therapeutische Stellenwert der Second-look-Operation bei Patienten mit malignen Hodentumoren.