Pathologic findings and therapeutic outcome of desperation post-chemotherapy retroperitoneal lymph node dissection in advanced germ cell cancer.
Increased serum tumor markers after cisplatin-based chemotherapy have usually been considered a contraindication to surgery because of the presence of persistent active germ cell elements. However, a select population of patients with elevated serum tumor markers have undergone post-chemotherapy retroperitoneal lymph node dissection (RPLND) with curative intent. We evaluated the role of surgery to resect retroperitoneal-only marker positive tumor. Long-term survival was observed in 50% of patients. Residual germ cell cancer was identified in 50% of patients, with a third alive at 5 years with no observed benefit from adjuvant chemotherapy. Select patients with increased tumor markers after chemotherapy are cured with surgery.
Beck
Stephen D W
SD
Department of Urology, Indiana University School of Medicine, Indianapolis, IN 46202, USA. stdbeck@iupui.edu
Foster
Richard S
RS
Bihrle
Richard
R
Einhorn
Lawrence H
LH
Donohue
John P
JP
D014408:Biomarkers, Tumor / Q000097:blood; D017024:Chemotherapy, Adjuvant; D006801:Humans; D007196:Indiana; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000601:surgery; D009367:Neoplasm Staging; D009373:Neoplasms, Germ Cell and Embryonal / Q000097:blood / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D018579:Patient Selection; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
D014408:Biomarkers, Tumor