title: Combined post-chemotherapy retroperitoneal lymph node dissection and resection of chest tumor under the same anesthetic is appropriate based on morbidity and tumor pathology.
abstract: OBJECTIVE
  We determine if post-chemotherapy resection of residual retroperitoneal and chest tumor under the same anesthetic is reasonable based on tumor pathology and morbidity, and if the finding of necrosis in the abdomen allows observation of chest tumor.
  
  
  METHODS
  We retrospectively reviewed 143 post-chemotherapy patients who underwent resection of residual retroperitoneal and chest disease under the same anesthetic.
  
  
  RESULTS
  Retroperitoneal pathology was generally predictive of chest pathology. Concordance existed in 77.5% of patients with necrosis, 70% with teratoma and 69% with cancer of the abdomen. However, the correlation was much stronger (86%) in predicting necrosis/fibrosis if cases were categorized as uncomplicated by Indiana University criteria. Although the morbidity of the combined approach is higher than that of standard post-chemotherapy retroperitoneal lymph node dissection, it was acceptable.
  
  
  CONCLUSIONS
  The morbidity of post-chemotherapy retroperitoneal lymph node dissection and resection of chest disease under the same anesthetic is acceptable. Retroperitoneal pathology generally predicts chest pathology but this correlation is much stronger if the case is uncomplicated based on our criteria. In an uncomplicated case the discovery of necrosis of the abdomen allows observation of chest tumor.
authors.affiliation: Indiana University Medical Center, Indianapolis, USA.
authors.forename: P G
authors.initials: PG
authors.lastname: Tognoni
authors.forename: R S
authors.initials: RS
authors.lastname: Foster
authors.forename: P
authors.initials: P
authors.lastname: McGraw
authors.forename: D
authors.initials: D
authors.lastname: Heilman
authors.forename: R
authors.initials: R
authors.lastname: Bihrle
authors.forename: R G
authors.initials: RG
authors.lastname: Rowland
authors.forename: G R
authors.initials: GR
authors.lastname: Wahle
authors.forename: L H
authors.initials: LH
authors.lastname: Einhorn
authors.forename: J P
authors.initials: JP
authors.lastname: Donohue
authors.forename: P G
authors.initials: PG
authors.lastname: Tognini
mesh_terms: D000758:Anesthesia; D000970:Antineoplastic Agents / Q000627:therapeutic use; D005355:Fibrosis; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D009017:Morbidity; D009336:Necrosis; D018365:Neoplasm, Residual; D012186:Retroperitoneal Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D012189:Retrospective Studies; D013736:Testicular Neoplasms / Q000188:drug therapy / Q000473:pathology; D013899:Thoracic Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D019616:Thoracic Surgical Procedures
chemical_list: D000970:Antineoplastic Agents