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CC BY-NC-ND 4.0 · South Asian J Cancer 2016; 05(01): 20-22
DOI: 10.4103/2278-330X.179702
GCT Review Article

Surgical controversies in the management of post-chemotherapy nonretroperitoneal residual disease in metastatic nonseminomatous germ cell tumors

Durgatosh Pandey
Department of Surgical Oncology, Dr BRA Institute Research Cancer Hospital, All India Institute of Medical Sciences, Delhi
,
Pankaj Kumar Garg
Department of Surgical Oncology, Dr BRA Institute Research Cancer Hospital, All India Institute of Medical Sciences, Delhi
Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi
,
Mukur Dipi Ray
Department of Surgical Oncology, Dr BRA Institute Research Cancer Hospital, All India Institute of Medical Sciences, Delhi
,
Ashutosh Mishra
Department of Surgical Oncology, Dr BRA Institute Research Cancer Hospital, All India Institute of Medical Sciences, Delhi
› Institutsangaben Source of Support: Nill.
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Abstract

Following the advent of platinum-based chemotherapy, Surgery, excepting orchidectomy, has become an adjunct treatment in the management of metastatic non-seminomatous germ cell tumors (NSGCT). Role of surgery comes into play in metastatic NSGCT when residual disease persists following standard chemotherapy. Surgical excision of all post chemotherapy residual disease at all places, whenever surgically feasible with acceptable morbidity and mortality, should be undertaken. As histopathological examination of the excised postchemotherapy residue shows only necrosis and fibrosis in significant number of patients; surgical exercise in this group of patients seems futile and unwarranted retrospectively. This issue becomes more contentious when surgeons are confronted with multiple nonretroperitoneal post chemotherapy residues. This article aims to deal with the management of postchemotherapy nonretroperitoneal residues in metastatic NSGCT.

Key words

Germ cell tumors - metastasis - postchemotherapy - surgery


Publikationsverlauf

Artikel online veröffentlicht:
30. Dezember 2020

© 2016. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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  • References

  • 1 Vasdev N, Moon A, Thorpe AC. Classification, epidemiology and therapies for testicular germ cell tumours. Int J Dev Biol 2013;57:133-9.
  • 2 Kesler KA, Kruter LE, Perkins SM, Rieger KM, Sullivan KJ, Runyan ML, et al. Survival after resection for metastatic testicular nonseminomatous germ cell cancer to the lung or mediastinum. Ann Thorac Surg 2011;91:1085-93.
  • 3 Daneshmand S, Albers P, Fosså SD, Heidenreich A, Kollmannsberger C, Krege S, et al. Contemporary management of postchemotherapy testis cancer. Eur Urol 2012;62:867-76.
  • 4 Gori S, Porrozzi S, Roila F, Gatta G, De Giorgi U, Marangolo M. Germ cell tumours of the testis. Crit Rev Oncol Hematol 2005;53:141-64.
  • 5 Fizazi K, Tjulandin S, Salvioni R, Germà-Lluch JR, Bouzy J, Ragan D, et al. Viable malignant cells after primary chemotherapy for disseminated nonseminomatous germ cell tumors: Prognostic factors and role of postsurgery chemotherapy – Results from an international study group. J Clin Oncol 2001;19:2647-57.
  • 6 Pfannenberg AC, Oechsle K, Bokemeyer C, Kollmannsberger C, Dohmen BM, Bares R, et al. The role of [(18) F] FDG-PET, CT/MRI and tumor marker kinetics in the evaluation of post chemotherapy residual masses in metastatic germ cell tumors – Prospects for management. World J Urol 2004;22:132-9.
  • 7 Logothetis CJ, Samuels ML, Trindade A, Johnson DE. The growing teratoma syndrome. Cancer 1982;50:1629-35.
  • 8 Motzer RJ, Amsterdam A, Prieto V, Sheinfeld J, Murty VV, Mazumdar M, et al. Teratoma with malignant transformation: Diverse malignant histologies arising in men with germ cell tumors. J Urol 1998;159:133-8.
  • 9 Ahmed T, Bosl GJ, Hajdu SI. Teratoma with malignant transformation in germ cell tumors in men. Cancer 1985;56:860-3.
  • 10 Donadio AC, Motzer RJ, Bajorin DF, Kantoff PW, Sheinfeld J, Houldsworth J, et al. Chemotherapy for teratoma with malignant transformation. J Clin Oncol 2003;21:4285-91.
  • 11 Fox EP, Weathers TD, Williams SD, Loehrer PJ, Ulbright TM, Donohue JP, et al. Outcome analysis for patients with persistent nonteratomatous germ cell tumor in postchemotherapy retroperitoneal lymph node dissections. J Clin Oncol 1993;11:1294-9.
  • 12 Sim HG, Lange PH, Lin DW. Role of post-chemotherapy surgery in germ cell tumors. Urol Clin North Am 2007;34:199-217.
  • 13 Liu D, Abolhoda A, Burt ME, Martini N, Bains MS, Downey RJ, et al. Pulmonary metastasectomy for testicular germ cell tumors: A 28-year experience. Ann Thorac Surg 1998;66:1709-14.
  • 14 Steyerberg EW, Keizer HJ, Messemer JE, Toner GC, Schraffordt Koops H, Fosså SD, et al. Residual pulmonary masses after chemotherapy for metastatic nonseminomatous germ cell tumor. Prediction of histology. ReHiT Study Group. Cancer 1997;79:345-55.
  • 15 Katz MH, McKiernan JM. Treatment of nonretroperitoneal residual germ cell tumor masses. Urol Oncol 2005;23:431-9.
  • 16 Lin DW, Lange PH. Editorial comment on “Treatment of nonretroperitoneal residual germ cell tumor masses”. Urol Oncol 2005;23:439-40.
  • 17 Besse B, Grunenwald D, Fléchon A, Caty A, Chevreau C, Culine S, et al. Nonseminomatous germ cell tumors: Assessing the need for postchemotherapy contralateral pulmonary resection in patients with ipsilateral complete necrosis. J Thorac Cardiovasc Surg 2009;137:448-52.
  • 18 Katz MH, McKiernan JM. Management of non-retroperitoneal residual germ cell tumor masses. Urol Clin North Am 2007;34:235-43.
  • 19 Hahn TL, Jacobson L, Einhorn LH, Foster R, Goulet RJ Jr. Hepatic resection of metastatic testicular carcinoma: A further update. Ann Surg Oncol 1999;6:640-4.
  • 20 Rivoire M, Elias D, De Cian F, Kaemmerlen P, Théodore C, Droz JP. Multimodality treatment of patients with liver metastases from germ cell tumors: The role of surgery. Cancer 2001;92:578-87.
  • 21 Copson E, McKendrick J, Hennessey N, Tung K, Mead GZ. Liver metastases in germ cell cancer: Defining a role for surgery after chemotherapy. BJU Int 2004;94:552-8.
  • 22 Mehra S, Liu J, Gupta A, Sheinfeld J, Kraus D. Cervical metastasis of germ cell tumors: Evaluation, management, complications, and outcomes. Laryngoscope 2012;122:286-90.
  • 23 Weisberger EC, McBride LC. Modified neck dissection for metastatic nonseminomatous testicular carcinoma. Laryngoscope 1999;109:1241-4.
  • 24 van Vledder MG, van der Hage JA, Kirkels WJ, Oosterhuis JW, Verhoef C, de Wilt JH. Cervical lymph node dissection for metastatic testicular cancer. Ann Surg Oncol 2010;17:1682-7.