Surgical treatment of pulmonary metastases in germ-cell testicular cancer patients--long-term results.
OBJECTIVE
The aim of this prospective clinical study is to evaluate our 20-year experience with surgical treatment of pulmonary metastases in germ-cell testicular cancer and discuss the optimal therapeutical approach.


BACKGROUND
Authors presents 63 patients who were surgically treated in the period from 1988 to 2008 for pulmonary metastases in germ cell testicular cancer. All patients were allocated for surgical treatment after undergoing cisplatin-based combination chemotherapy.


METHODS
In a group of 63 patients, 57 thoracotomias and 27 sternotomias were performed. In pulmonary procedures small atypical resections prevailed--84%. Postoperative mortality was 1.2%. Decision for follow-up treatment was made on basis of histological investigation of metastases. In some cases when viable tumor tissue was found (16% patients), further chemotherapy was administered. The rest of patients were monitored intensively.


RESULTS
In a long-term follow-up, remission was achieved in almost 60% of patients.


CONCLUSIONS
We suggest that lung metastasectomy as the secondary treatment in generalized germ cell testicular cancer should be fully warranted (Fig. 3, Ref. 16). Full Text (Free, PDF) www.bmj.sk.
Schnorrer
M
M
3rd Department of Surgery, Comenius University Medical School, Hospital Milosrdni bratia, Bratislava, Slovakia. Milan.schnorrer@milosrdni.sk
Ondrus
D
D
Vichova
B
B
Oravsky
M
M
Bak
V
V
D000293:Adolescent; D000328:Adult; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009373:Neoplasms, Germ Cell and Embryonal / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D015996:Survival Rate; D013736:Testicular Neoplasms / Q000401:mortality / Q000473:pathology*; D055815:Young Adult