Does the Presence of Extranodal Extension in Pathological Stage B1 Nonseminomatous Germ Cell Tumor Necessitate Adjuvant Chemotherapy?

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

Research output: Contribution to journalArticle

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Abstract

Purpose: The presence of extranodal extension identified at primary retroperitoneal lymph node dissection has been associated with an increased risk of disease recurrence, and as such these patients are sometimes treated with adjuvant chemotherapy. We decided to evaluate the significance of extranodal extension on disease-free survival in patients with pathological stage B nonseminomatous germ cell tumor who did not receive adjuvant chemotherapy. Materials and Methods: A retrospective review of our testicular cancer database was performed to identify all patients with clinical stage A nonseminomatous germ cell tumor who underwent primary retroperitoneal lymph node dissection and were found to have retroperitoneal metastasis with 5 or fewer involved nodes and no metastatic node larger than 2 cm. No patient received adjuvant chemotherapy, and all had a minimum followup of 24 months. A single pathologist (LC), who was blinded to clinical outcome, reviewed the retroperitoneal nodal package to identify the presence or absence of extranodal extension, defined as cancer perforating through the lymph node capsule into perinodal tissue. Results: A total of 80 patients were identified with a median followup 48 months, and a 2 and 5-year disease-free survival of 75%. Extranodal extension was present in 23 patients and absent in 57 patients with a median followup of 54 and 44 months, respectively. The 5-year disease-free survival for patients with and without extranodal extension was 74% and 75%, respectively (p = 0.67). Conclusions: We were unable to detect any prognostic significance of extranodal extension in patients found to have retroperitoneal metastasis at primary retroperitoneal lymph node dissection.

Original languageEnglish
Pages (from-to)944-946
Number of pages3
JournalJournal of Urology
Volume177
Issue number3
DOIs
StatePublished - Mar 2007

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Adjuvant Chemotherapy
Lymph Node Excision
Disease-Free Survival
Neoplasm Metastasis
Nonseminomatous germ cell tumor
Testicular Neoplasms
Capsules
Lymph Nodes
Databases
Recurrence

Keywords

  • drug therapy
  • lymph node excision
  • testicular neoplasms

ASJC Scopus subject areas

  • Urology

Cite this

Does the Presence of Extranodal Extension in Pathological Stage B1 Nonseminomatous Germ Cell Tumor Necessitate Adjuvant Chemotherapy? / Beck, Stephen D W; Cheng, Liang; Bihrle, Richard; Donohue, John P.; Foster, Richard.

In: Journal of Urology, Vol. 177, No. 3, 03.2007, p. 944-946.

Research output: Contribution to journalArticle

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