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 Foster, Richard Bihrle, Liang Cheng, John P. Donohue

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

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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

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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 Richard Foster and Richard Bihrle and Liang Cheng and Donohue, {John P.}",
year = "2005",
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language = "English",
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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

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.

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KW - Retroperitoneal space

KW - Testicular neoplasms

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