Does the histology of nodal metastasis predict systemic relapse after retroperitoneal lymph node dissection in pathological stage B1 germ cell tumors?

Stephen D.W. Beck, Richard S. Foster, Richard Bihrle, Liang Cheng, John P. Donohue

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Purpose: We evaluated the prognostic significance of the histology of metastatic lymph nodes to predict postoperative relapse in pathological stage B1 nonseminomatous germ cell tumor (NSGCT). Materials and Methods: A retrospective review of the testicular cancer database was performed to identify all patients with clinical stage A NSGCT who underwent primary retroperitoneal lymph node dissection and were found to have pathological stage B1 disease. No patient received adjuvant chemotherapy and minimal followup was 24 months. Results: A total of 118 patients were identified with a 5-year disease-free survival (DFS) of 68% and a median followup of 43 months. Embryonal cell carcinoma was identified in 92 of 118 (77%) surgical specimens, which was significantly greater than the presence of teratoma (22%), seminoma (16%) and yolk sac (14.4%, p ≤0.001) with no difference in 5-year DFS comparing the presence or absence of each histology. Solitary histology was noted in 88 of 118 patients (74.5%). Embryonal cell carcinoma was the most common single histology identified at surgery at 64 of 88 (73%), with the incidence of seminoma, teratoma and yolk sac being 12.5%, 9.0% and 5.5%, respectively (p ≤0.001). There was no statistical difference in DFS for each of the solitary histological subtypes (p=0.67). Recurrence rates were similar for pure embryonal cell carcinoma (69%), mixed embryonal cell carcinoma (63%) and no embryonal cell carcinoma (73%) in the retroperitoneum (p=0.63). Conclusions: Retroperitoneal histology does not appear to predict outcome in patients with pathological stage B1 NSGCT.

Original languageEnglish (US)
Pages (from-to)1287-1290
Number of pages4
JournalJournal of Urology
Volume174
Issue number4 I
DOIs
StatePublished - Oct 2005

Fingerprint

Embryonal Carcinoma Stem Cells
Germ Cell and Embryonal Neoplasms
Lymph Node Excision
Histology
Neoplasm Metastasis
Recurrence
Disease-Free Survival
Yolk Sac
Seminoma
Teratoma
Testicular Neoplasms
Adjuvant Chemotherapy
Lymph Nodes
Databases
Incidence
Nonseminomatous germ cell tumor

Keywords

  • Histology
  • Retroperitoneal space
  • Testicular neoplasms

ASJC Scopus subject areas

  • Urology

Cite this

@article{a048264ed2e548a099111458456dad87,
title = "Does the histology of nodal metastasis predict systemic relapse after retroperitoneal lymph node dissection in pathological stage B1 germ cell tumors?",
abstract = "Purpose: We evaluated the prognostic significance of the histology of metastatic lymph nodes to predict postoperative relapse in pathological stage B1 nonseminomatous germ cell tumor (NSGCT). Materials and Methods: A retrospective review of the testicular cancer database was performed to identify all patients with clinical stage A NSGCT who underwent primary retroperitoneal lymph node dissection and were found to have pathological stage B1 disease. No patient received adjuvant chemotherapy and minimal followup was 24 months. Results: A total of 118 patients were identified with a 5-year disease-free survival (DFS) of 68{\%} and a median followup of 43 months. Embryonal cell carcinoma was identified in 92 of 118 (77{\%}) surgical specimens, which was significantly greater than the presence of teratoma (22{\%}), seminoma (16{\%}) and yolk sac (14.4{\%}, p ≤0.001) with no difference in 5-year DFS comparing the presence or absence of each histology. Solitary histology was noted in 88 of 118 patients (74.5{\%}). Embryonal cell carcinoma was the most common single histology identified at surgery at 64 of 88 (73{\%}), with the incidence of seminoma, teratoma and yolk sac being 12.5{\%}, 9.0{\%} and 5.5{\%}, respectively (p ≤0.001). There was no statistical difference in DFS for each of the solitary histological subtypes (p=0.67). Recurrence rates were similar for pure embryonal cell carcinoma (69{\%}), mixed embryonal cell carcinoma (63{\%}) and no embryonal cell carcinoma (73{\%}) in the retroperitoneum (p=0.63). Conclusions: Retroperitoneal histology does not appear to predict outcome in patients with pathological stage B1 NSGCT.",
keywords = "Histology, Retroperitoneal space, Testicular neoplasms",
author = "Beck, {Stephen D.W.} and Foster, {Richard S.} and Richard Bihrle and Liang Cheng and Donohue, {John P.}",
year = "2005",
month = "10",
doi = "10.1097/01.ju.0000173925.80551.9e",
language = "English (US)",
volume = "174",
pages = "1287--1290",
journal = "Journal of Urology",
issn = "0022-5347",
publisher = "Elsevier Inc.",
number = "4 I",

}

TY - JOUR

T1 - Does the histology of nodal metastasis predict systemic relapse after retroperitoneal lymph node dissection in pathological stage B1 germ cell tumors?

AU - Beck, Stephen D.W.

AU - Foster, Richard S.

AU - Bihrle, Richard

AU - Cheng, Liang

AU - Donohue, John P.

PY - 2005/10

Y1 - 2005/10

N2 - Purpose: We evaluated the prognostic significance of the histology of metastatic lymph nodes to predict postoperative relapse in pathological stage B1 nonseminomatous germ cell tumor (NSGCT). Materials and Methods: A retrospective review of the testicular cancer database was performed to identify all patients with clinical stage A NSGCT who underwent primary retroperitoneal lymph node dissection and were found to have pathological stage B1 disease. No patient received adjuvant chemotherapy and minimal followup was 24 months. Results: A total of 118 patients were identified with a 5-year disease-free survival (DFS) of 68% and a median followup of 43 months. Embryonal cell carcinoma was identified in 92 of 118 (77%) surgical specimens, which was significantly greater than the presence of teratoma (22%), seminoma (16%) and yolk sac (14.4%, p ≤0.001) with no difference in 5-year DFS comparing the presence or absence of each histology. Solitary histology was noted in 88 of 118 patients (74.5%). Embryonal cell carcinoma was the most common single histology identified at surgery at 64 of 88 (73%), with the incidence of seminoma, teratoma and yolk sac being 12.5%, 9.0% and 5.5%, respectively (p ≤0.001). There was no statistical difference in DFS for each of the solitary histological subtypes (p=0.67). Recurrence rates were similar for pure embryonal cell carcinoma (69%), mixed embryonal cell carcinoma (63%) and no embryonal cell carcinoma (73%) in the retroperitoneum (p=0.63). Conclusions: Retroperitoneal histology does not appear to predict outcome in patients with pathological stage B1 NSGCT.

AB - Purpose: We evaluated the prognostic significance of the histology of metastatic lymph nodes to predict postoperative relapse in pathological stage B1 nonseminomatous germ cell tumor (NSGCT). Materials and Methods: A retrospective review of the testicular cancer database was performed to identify all patients with clinical stage A NSGCT who underwent primary retroperitoneal lymph node dissection and were found to have pathological stage B1 disease. No patient received adjuvant chemotherapy and minimal followup was 24 months. Results: A total of 118 patients were identified with a 5-year disease-free survival (DFS) of 68% and a median followup of 43 months. Embryonal cell carcinoma was identified in 92 of 118 (77%) surgical specimens, which was significantly greater than the presence of teratoma (22%), seminoma (16%) and yolk sac (14.4%, p ≤0.001) with no difference in 5-year DFS comparing the presence or absence of each histology. Solitary histology was noted in 88 of 118 patients (74.5%). Embryonal cell carcinoma was the most common single histology identified at surgery at 64 of 88 (73%), with the incidence of seminoma, teratoma and yolk sac being 12.5%, 9.0% and 5.5%, respectively (p ≤0.001). There was no statistical difference in DFS for each of the solitary histological subtypes (p=0.67). Recurrence rates were similar for pure embryonal cell carcinoma (69%), mixed embryonal cell carcinoma (63%) and no embryonal cell carcinoma (73%) in the retroperitoneum (p=0.63). Conclusions: Retroperitoneal histology does not appear to predict outcome in patients with pathological stage B1 NSGCT.

KW - Histology

KW - Retroperitoneal space

KW - Testicular neoplasms

UR - http://www.scopus.com/inward/record.url?scp=24944526635&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=24944526635&partnerID=8YFLogxK

U2 - 10.1097/01.ju.0000173925.80551.9e

DO - 10.1097/01.ju.0000173925.80551.9e

M3 - Article

C2 - 16145394

AN - SCOPUS:24944526635

VL - 174

SP - 1287

EP - 1290

JO - Journal of Urology

JF - Journal of Urology

SN - 0022-5347

IS - 4 I

ER -