Is retroperitoneal histology predictive of liver histology at concurrent post-chemotherapy retroperitoneal lymph node dissection and hepatic resection?

Niels Erik B Jacobsen, Stephen D W Beck, Lewis E. Jacobson, Richard Bihrle, Lawrence Einhorn, Richard Foster

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Purpose: We identified factors predicting liver histology in patients with nonseminomatous germ cell tumor undergoing concurrent post-chemotherapy retroperitoneal lymph node dissection and liver resection. Materials and Methods: We reviewed the Indiana University testis cancer database to identify all patients with nonseminomatous germ cell tumor and liver metastasis who underwent post-chemotherapy retroperitoneal lymph node dissection and liver resection between 1976 and 2006. Results: A total of 59 patients met study inclusion criteria. Necrosis, teratoma and cancer were identified in 31%, 46% and 24% of retroperitoneal specimens, and in 73%, 17% and 10% of liver specimens, respectively. Concordance between retroperitoneal and liver histology was 49% overall, including 94% for necrosis, 26% for teratoma and 36% for cancer. Liver necrosis alone was found in 94%, 70% and 50% of patients with retroperitoneal necrosis, teratoma and cancer, respectively. Conclusions: The overall rate of histological discordance between retroperitoneal and liver histology was 51% with 73% of all liver specimens containing necrosis only. Retroperitoneal necrosis is highly predictive of hepatic necrosis (94%). Management for liver lesions at post-chemotherapy retroperitoneal lymph node dissection must be individualized. Observation may be warranted for liver lesions requiring complicated hepatic surgery regardless of retroperitoneal pathology.

Original languageEnglish
Pages (from-to)949-953
Number of pages5
JournalJournal of Urology
Volume184
Issue number3
DOIs
StatePublished - Sep 2010

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Lymph Node Excision
Histology
Drug Therapy
Liver
Necrosis
Teratoma
Neoplasms
Testicular Neoplasms
Observation
Databases
Pathology
Neoplasm Metastasis

Keywords

  • liver
  • lymph node excision
  • neoplasm metastasis
  • neoplasms, germ cell and embryonal
  • testis

ASJC Scopus subject areas

  • Urology
  • Medicine(all)

Cite this

Is retroperitoneal histology predictive of liver histology at concurrent post-chemotherapy retroperitoneal lymph node dissection and hepatic resection? / Jacobsen, Niels Erik B; Beck, Stephen D W; Jacobson, Lewis E.; Bihrle, Richard; Einhorn, Lawrence; Foster, Richard.

In: Journal of Urology, Vol. 184, No. 3, 09.2010, p. 949-953.

Research output: Contribution to journalArticle

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abstract = "Purpose: We identified factors predicting liver histology in patients with nonseminomatous germ cell tumor undergoing concurrent post-chemotherapy retroperitoneal lymph node dissection and liver resection. Materials and Methods: We reviewed the Indiana University testis cancer database to identify all patients with nonseminomatous germ cell tumor and liver metastasis who underwent post-chemotherapy retroperitoneal lymph node dissection and liver resection between 1976 and 2006. Results: A total of 59 patients met study inclusion criteria. Necrosis, teratoma and cancer were identified in 31{\%}, 46{\%} and 24{\%} of retroperitoneal specimens, and in 73{\%}, 17{\%} and 10{\%} of liver specimens, respectively. Concordance between retroperitoneal and liver histology was 49{\%} overall, including 94{\%} for necrosis, 26{\%} for teratoma and 36{\%} for cancer. Liver necrosis alone was found in 94{\%}, 70{\%} and 50{\%} of patients with retroperitoneal necrosis, teratoma and cancer, respectively. Conclusions: The overall rate of histological discordance between retroperitoneal and liver histology was 51{\%} with 73{\%} of all liver specimens containing necrosis only. Retroperitoneal necrosis is highly predictive of hepatic necrosis (94{\%}). Management for liver lesions at post-chemotherapy retroperitoneal lymph node dissection must be individualized. Observation may be warranted for liver lesions requiring complicated hepatic surgery regardless of retroperitoneal pathology.",
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AU - Einhorn, Lawrence

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