Persistent cancer in postchemotherapy retroperitoneal lymph-node dissection: outcome analysis.

Abstract:

:Surgery following chemotherapy for treatment of metastatic testis cancer is reserved for partial remissions with localized tumors considered resectable. After primary chemotherapy, about 90% will have teratoma or necrosis and only 10% will have cancer. The concept of two cycles of post operative chemotherapy in this small group with cancer is supported by a 70% long term cure rate. A more difficult group of patients are those who have had not only primary but also salvage chemotherapy for refractory tumor. About 55% of these patients undergoing post (salvage) chemotherapy RPLND surgery have persistent cancer in the resected specimen. There is no data to support the routine use of repeat salvage chemotherapy post operatively. Of 91 patients presenting for surgery post salvage chemotherapy, 53 were considered completely resected and 36 incompletely resected. Of the 53 realistic candidates for cure with complete resections, 25 were given post operative repeat salvage chemotherapy and 28 received none. 9 (36%) receiving more chemotherapy remained NED and 12 (43%) receiving none remained NED. 12 in each group died of disease. Therefore, there is no data to support routine repeat salvage chemotherapy in patients considered completely resected who had already received salvage chemotherapy pre-operatively. Rather the outcome in this cohort depends more on the completeness of its resectability.

journal_name

World J Urol

journal_title

World journal of urology

authors

Donohue JP,Fox EP,Williams SD,Loehrer PJ,Ulbright TM,Einhorn LH,Weathers TD

doi

10.1007/BF00185671

subject

Has Abstract

pub_date

1994-01-01 00:00:00

pages

190-5

issue

4

eissn

0724-4983

issn

1433-8726

journal_volume

12

pub_type

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