Integration of surgery and systemic therapy: results and principles of integration.
Eight hundred seventy patients with metastatic nonseminomatous germ cell cancer underwent postchemotherapy retroperitoneal lymph node dissection (PC-RPLND) for resection of residual disease. Several risk factors for relapse and survival were identified as highly significant (P = .00001), namely, presence of residual cancer in the specimen before salvage chemotherapy programs, tumor marker elevation, need for "re-do" PC-RPLND, or unresectability. Although more than half of the entire group (52.5%) had one or more of these risk factors, 67.5% are long-term survivors following PC-RPLND. The remaining 47.5% were referred after primary chemotherapy, without risk factors. Only 9.8% relapsed and 95.5% survived.
Donohue
J P
JP
Indiana University School of Medicine, Indianapolis 46202-5289, USA.
Leviovitch
I
I
Foster
R S
RS
Baniel
J
J
Tognoni
P
P
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003131:Combined Modality Therapy; D018237:Germinoma / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000401:mortality; D015996:Survival Rate; D013736:Testicular Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery*