Combined post-chemotherapy retroperitoneal lymph node dissection and resection of chest tumor under the same anesthetic is appropriate based on morbidity and tumor pathology

Piero G. Tognini, Richard Foster, Peter McGraw, Douglas Heilman, Richard Bihrle, Randall G. Rowland, Gregory R. Wahle, Lawrence Einhorn, John P. Donohue

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Abstract

Purpose: We determine if post-chemotherapy resection of residual retroperitoneal and chest tumor under the same anesthetic is reasonable based on tumor pathology and morbidity, and if the finding of necrosis in the abdomen allows observation of chest tumor. Materials and Methods: We retrospectively reviewed 143 post-chemotherapy patients who underwent resection of residual retroperitoneal and chest disease under the same anesthetic. Results: Retroperitoneal pathology was generally predictive of chest pathology. Concordance existed in 77.5% of patients with necrosis, 70% with teratoma and 69% with cancer of the abdomen. However, the correlation was much stronger (86%) in predicting necrosis/fibrosis if cases were categorized as uncomplicated by Indiana University criteria. Although the morbidity of the combined approach is higher than that of standard post- chemotherapy retroperitoneal lymph node dissection, it was acceptable. Conclusions: The morbidity of post-chemotherapy retroperitoneal lymph node dissection and resection of chest disease under the same anesthetic is acceptable. Retroperitoneal pathology generally predicts chest pathology but this correlation is much stronger if the case is uncomplicated based on our criteria. In an uncomplicated case the discovery of necrosis of the abdomen allows observation of chest tumor.

Original languageEnglish
Pages (from-to)1833-1835
Number of pages3
JournalJournal of Urology
Volume159
Issue number6
StatePublished - Jun 1998

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Lymph Node Excision
Anesthetics
Thorax
Pathology
Morbidity
Drug Therapy
Necrosis
Neoplasms
Abdomen
Observation
Teratoma
Fibrosis

Keywords

  • Anesthesia
  • Drug therapy
  • Morbidity
  • Retroperitoneal neoplasms
  • Thoracic neoplasms

ASJC Scopus subject areas

  • Urology

Cite this

Combined post-chemotherapy retroperitoneal lymph node dissection and resection of chest tumor under the same anesthetic is appropriate based on morbidity and tumor pathology. / Tognini, Piero G.; Foster, Richard; McGraw, Peter; Heilman, Douglas; Bihrle, Richard; Rowland, Randall G.; Wahle, Gregory R.; Einhorn, Lawrence; Donohue, John P.

In: Journal of Urology, Vol. 159, No. 6, 06.1998, p. 1833-1835.

Research output: Contribution to journalArticle

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abstract = "Purpose: We determine if post-chemotherapy resection of residual retroperitoneal and chest tumor under the same anesthetic is reasonable based on tumor pathology and morbidity, and if the finding of necrosis in the abdomen allows observation of chest tumor. Materials and Methods: We retrospectively reviewed 143 post-chemotherapy patients who underwent resection of residual retroperitoneal and chest disease under the same anesthetic. Results: Retroperitoneal pathology was generally predictive of chest pathology. Concordance existed in 77.5{\%} of patients with necrosis, 70{\%} with teratoma and 69{\%} with cancer of the abdomen. However, the correlation was much stronger (86{\%}) in predicting necrosis/fibrosis if cases were categorized as uncomplicated by Indiana University criteria. Although the morbidity of the combined approach is higher than that of standard post- chemotherapy retroperitoneal lymph node dissection, it was acceptable. Conclusions: The morbidity of post-chemotherapy retroperitoneal lymph node dissection and resection of chest disease under the same anesthetic is acceptable. Retroperitoneal pathology generally predicts chest pathology but this correlation is much stronger if the case is uncomplicated based on our criteria. In an uncomplicated case the discovery of necrosis of the abdomen allows observation of chest tumor.",
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AU - Foster, Richard

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AU - Heilman, Douglas

AU - Bihrle, Richard

AU - Rowland, Randall G.

AU - Wahle, Gregory R.

AU - Einhorn, Lawrence

AU - Donohue, John P.

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