Aortic replacement during post-chemotherapy retroperitoneal lymph node dissection

Stephen D.W. Beck, Richard S. Foster, Richard Bihrle, Michael O. Koch, Gregory R. Wahle, John P. Donohue

Research output: Contribution to journalArticle

34 Scopus citations

Abstract

Purpose: We reviewed the records of 15 patients with metastatic germ cell cancer who underwent aortic resection and replacement during post-chemotherapy retroperitoneal lymph node dissection to determine the morbidity and the therapeutic benefit. Materials and Methods: Between 1970 and 1998, 1,250 patients underwent post-chemotherapy retroperitoneal lymph node dissection. Our retrospective review revealed that 15 patients underwent aortic replacement at that operation. Results: In addition to aortic replacement 11 patients underwent 15 additional procedures, including nephrectomy in 7, vena caval resection in 3, pulmonary resection in 1, small bowel resection in 2, 1 hepatic resection in 1 and L4 vertebrectomy in 1. No patient had necrosis as the only pathological condition. Three patients (20%) had teratoma and 12 (80%) had viable tumor in the retroperitoneal specimen. All 4 patients who underwent post-chemotherapy retroperitoneal lymph node dissection and aortic replacement after induction chemotherapy alone have no evidence of disease. Only 1 of the 11 patients who received salvage chemotherapy with or without previous post-chemotherapy retroperitoneal lymph node dissection have no evidence of disease. Overall 33% of the patients have no evidence of disease. There were no graft related complications. Conclusions: Aortic resection at post-chemotherapy retroperitoneal lymph node dissection is justified based on therapeutic benefit and morbidity.

Original languageEnglish (US)
Pages (from-to)1517-1520
Number of pages4
JournalJournal of Urology
Volume165
Issue number5 I
DOIs
StatePublished - Jan 1 2001

Keywords

  • Aorta
  • Germinoma
  • Lymph nodes
  • Metastases
  • Testis

ASJC Scopus subject areas

  • Urology

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