title: Testicular tumors: residual retroperitoneal mass surgery after chemotherapy;Is it  possible to predict their histology?
abstract: OBJECTIVE
  We present our series of residual retroperitoneal mass surgery after chemotherapy. We evaluate possible preoperative parameters that can predict the retroperitoneal mass histology. Survival and relapse rates were also evaluated.
  
  
  METHODS
  We reviewed sixty resections of residual retroperitoneal masses of testicular tumours after chemotherapy performed at our department between 1995 and 2007. We evaluate the relationship between histology of the retroperitoneal mass and possible risk factors, such as outcomes after chemotherapy, which was evaluated as changes in the size of the retroperitoneal mass, and negativization of serum tumor markers. We also evaluate histology and size of the primary testicular cancer.
  
  
  RESULTS
  The histology of retroperitoneal mass was necrosis or fibrosis in 25 (42%) cases, teratoma in 29 (48%) and viable tumor in 6 (10%). The size of the retroperitoneal mass decreased after the chemotherapy in 62% cases; moreover negative serum tumor markers were found in 87%. Elevated values of human chorionic gonadotropin were associated with viable cells in the retroperitoneal mass (p=0.014) and, the presence of teratoma in the primary tumor may be associated with teratoma in the retroperitoneal mass histology (p=0.002). However, no other preoperative factors that predict the residual mass histology were found. Repeated resections of retroperitoneal masses were required in four patients and 9 patients died during follow-up.
  
  
  CONCLUSIONS
  We cannot determine preoperative parameters that accurately predict the histology of retroperitoneal masses. Therefore, resection of residual retroperitoneal masses after chemotherapy in non-seminomatous germ cell tumours must be performed.
authors.affiliation: Department of Urology and Medical Oncology, Hospital Universitario 12 de Octubre, Madrid, Spain. josemedinapolo@telefonica.net
authors.forename: José
authors.initials: J
authors.lastname: Medina-Polo
authors.forename: Víctor
authors.initials: V
authors.lastname: Martínez-Silva
authors.forename: Mario
authors.initials: M
authors.lastname: Domínguez-Esteban
authors.forename: Federico
authors.initials: F
authors.lastname: de la Rosa-Kehrmann
authors.forename: Felipe
authors.initials: F
authors.lastname: Villacampa-Aubá
authors.forename: Daniel
authors.initials: D
authors.lastname: Castellano-Gauna
authors.forename: Rafael
authors.initials: R
authors.lastname: Díaz-González
mesh_terms: D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000032:analysis; D003131:Combined Modality Therapy; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D009373:Neoplasms, Germ Cell and Embryonal / Q000473:pathology; D011237:Predictive Value of Tests; D012186:Retroperitoneal Neoplasms / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D012189:Retrospective Studies; D016019:Survival Analysis; D013724:Teratoma / Q000473:pathology / Q000601:surgery; D013736:Testicular Neoplasms / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor