Pulmonary metastasectomy following chemotherapy in patients with testicular tumors: experience in 52 patients.
BACKGROUND
Surgical resection is an important form of treatment for residual post-chemotherapy pulmonary masses in patients with non-seminomatous germ cell tumors. We analyzed the outcome and prognostic factors after surgery.


METHODS
Between 1996 and 2001, 52 patients underwent pulmonary resection of thoracic masses following cisplatin-based chemotherapy. These patients' records were subsequently reviewed.


RESULTS
The overall 5-year survival rate was 75.8 %. A significantly longer survival was observed using multivariate analysis in patients with normal serum AFP and/or hCG tumor marker levels and after complete surgical resection. In patients with viable malignant tumor cells in the resected specimen and in patients with only necrosis/fibrosis or teratoma, the 5-year survival rates were 49.6 % and 82.8 %, respectively. This difference was only statistically significant in univariate analysis.


CONCLUSIONS
We conclude that pulmonary resection in metastatic non-seminomatous germ cell tumors is a safe and effective treatment modality. Incomplete resection and elevated tumor marker levels, AFP and/or hCG, were identified as prognosis-related criteria for a poor outcome in multivariate analysis.
Pfannschmidt
J
J
Department of Thoracic Surgery, Thoraxklinik Heidelberg, University of Heidelberg, Heidelberg, Germany. joachim.pfannschmidt@thoraxklinik-heidelberg.de
Zabeck
H
H
Muley
T
T
Dienemann
H
H
Hoffmann
H
H
D000293:Adolescent; D000328:Adult; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D018365:Neoplasm, Residual / Q000601:surgery; D009373:Neoplasms, Germ Cell and Embryonal / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016019:Survival Analysis; D013736:Testicular Neoplasms / Q000473:pathology*