title: Primary retroperitoneal germ cell tumours: excision via a thoracoabdominal extraperitoneal approach.
abstract: BACKGROUND
  Primary retroperitoneal germ cell tumours usually present as a large abdominal mass in young men. The testes are normal on examination and ultrasonography but there are usually raised serum levels of human chorionic gonadotrophin and/or alpha-fetoprotein.
  
  
  METHODS
  Fourteen men (median age 33 years) with primary retroperitoneal germ cell tumours were treated by chemotherapy followed by surgical resection of the primary tumour and metastases via a thoracoabdominal extraperitoneal approach.
  
  
  RESULTS
  There was minimal morbidity. The survival rate was 13 of 14 and the disease-free survival rate was 11 of 14 after a median follow-up of 15 months.
  
  
  CONCLUSIONS
  The thoracoabdominal extraperitoneal approach for the removal of retroperitoneal germ cell tumours and their metastases after chemotherapy improves tumour clearance, morbidity and recovery time compared with the transperitoneal anterior approach.
authors.affiliation: Department of Urology, Charing Cross Hospital, London, UK.
authors.forename: T J
authors.initials: TJ
authors.lastname: Christmas
authors.forename: A P
authors.initials: AP
authors.lastname: Doherty
authors.forename: G J
authors.initials: GJ
authors.lastname: Rustin
authors.forename: M J
authors.initials: MJ
authors.lastname: Seckl
authors.forename: E S
authors.initials: ES
authors.lastname: Newlands
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000097:blood; D006063:Chorionic Gonadotropin / Q000032:analysis; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D018237:Germinoma / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012186:Retroperitoneal Neoplasms / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: D014408:Biomarkers, Tumor; D006063:Chorionic Gonadotropin; D000509:alpha-Fetoproteins