title: Results of salvage retroperitoneal lymphadenectomy (RLA) in the treatment of patients with nonseminomatous germ cell tumours remaining marker positive after inductive chemotherapy.
abstract: The authors describe the evidence and results obtained in 21 out of 100 patients who underwent salvage retroperitoneal lymphadenectomy for advanced testicular cancer (UICC stage II/B bulky and stage III) in the period 1982-1993, and in whom inductive chemotherapy was not followed by marker conversion. It is stated that if AFP positivity is low (titres below 100 ng/ml) salvage retroperitoneal lymphadenectomy (RLA) is of high therapeutic value, whereas in all cases with HCG positivity or AFP titres higher than 500 ng/ml tumorous death ensued without exception. In our cases viable tumour residues occurred in 81%. Salvage resection was feasible in 76%, but every incomplete resection (19%) was followed by death due to tumour. In all but one of the cases marker positivity, an indicator of therapy-resistant viable tumour residues, persisted after having used more than four PVB combinations or changes in the chemotherapeutic regimen.
authors.affiliation: Department of Urology, Jahn Ferenc South-Pest Hospital, Budapest.
authors.forename: L
authors.initials: L
authors.lastname: Kisbenedek
authors.forename: I
authors.initials: I
authors.lastname: Bodrogi
authors.forename: P
authors.initials: P
authors.lastname: Szeldeli
authors.forename: M
authors.initials: M
authors.lastname: Baki
authors.forename: P
authors.initials: P
authors.lastname: Tenke
authors.forename: J
authors.initials: J
authors.lastname: Horti
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000378:metabolism*; D003131:Combined Modality Therapy; D005500:Follow-Up Studies; D018237:Germinoma / Q000378:metabolism / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D009367:Neoplasm Staging; D012187:Retroperitoneal Space / Q000601:surgery*; D012189:Retrospective Studies; D016879:Salvage Therapy; D013736:Testicular Neoplasms / Q000378:metabolism / Q000473:pathology / Q000628:therapy*
chemical_list: D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor