Management of Residual Mass in Germ Cell Tumors After Chemotherapy

Costantine Albany, Kenneth Kesler, Clint Cary

Research output: Contribution to journalReview article

2 Scopus citations

Abstract

Purpose of Review: The purpose of this review is to educate medical oncologists on the management of patients with residual germ cell tumors and the role of surgical resection after platinum-based chemotherapy. Recent Findings: Patients with non-seminomatous testicular cancer and residual enlarged retroperitoneal lymph nodes > 1 cm following induction chemotherapy with normal tumor markers should undergo a post-chemotherapy retroperitoneal lymph node dissection. All patients with primary mediastinal non-seminoma should undergo surgical resection of the mediastinal mass post-chemotherapy. These are complex surgeries and require expert surgeons in high-volume centers. Patients with advanced testicular seminoma who have residual masses less than 3 cm after chemotherapy can be observed without further intervention. Patients with a residual mass > 3 cm should be evaluated with PET scan after 6 weeks of chemotherapy. Residual mass with negative PET scan can be followed by surveillance while a positive PET scan requires further work up to rule out active disease.

Original languageEnglish (US)
Article number5
JournalCurrent oncology reports
Volume21
Issue number1
DOIs
StatePublished - Jan 1 2019

Keywords

  • Chemotherapy
  • Germ cell tumor
  • Non-seminoma
  • Primary mediastinal
  • Residual mass
  • Retroperitoneal lymph node dissection
  • Seminoma
  • Teratoma
  • Testis cancer

ASJC Scopus subject areas

  • Oncology

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