Management of Residual Mass in Germ Cell Tumors After Chemotherapy

Costantine Albany, Kenneth Kesler, K. Clinton Cary

Research output: Contribution to journalReview article

1 Citation (Scopus)

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

Fingerprint

Germ Cell and Embryonal Neoplasms
Drug Therapy
Positron-Emission Tomography
Seminoma
Induction Chemotherapy
Testicular Neoplasms
Residual Neoplasm
Tumor Biomarkers
Platinum
Lymph Node Excision
Lymph Nodes

Keywords

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

ASJC Scopus subject areas

  • Oncology

Cite this

Management of Residual Mass in Germ Cell Tumors After Chemotherapy. / Albany, Costantine; Kesler, Kenneth; Cary, K. Clinton.

In: Current Oncology Reports, Vol. 21, No. 1, 5, 01.01.2019.

Research output: Contribution to journalReview article

@article{0ce374518f9a48c28512acd389265a82,
title = "Management of Residual Mass in Germ Cell Tumors After Chemotherapy",
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.",
keywords = "Chemotherapy, Germ cell tumor, Non-seminoma, Primary mediastinal, Residual mass, Retroperitoneal lymph node dissection, Seminoma, Teratoma, Testis cancer",
author = "Costantine Albany and Kenneth Kesler and Cary, {K. Clinton}",
year = "2019",
month = "1",
day = "1",
doi = "10.1007/s11912-019-0758-6",
language = "English (US)",
volume = "21",
journal = "Current Oncology Reports",
issn = "1523-3790",
publisher = "Current Science, Inc.",
number = "1",

}

TY - JOUR

T1 - Management of Residual Mass in Germ Cell Tumors After Chemotherapy

AU - Albany, Costantine

AU - Kesler, Kenneth

AU - Cary, K. Clinton

PY - 2019/1/1

Y1 - 2019/1/1

N2 - 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.

AB - 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.

KW - Chemotherapy

KW - Germ cell tumor

KW - Non-seminoma

KW - Primary mediastinal

KW - Residual mass

KW - Retroperitoneal lymph node dissection

KW - Seminoma

KW - Teratoma

KW - Testis cancer

UR - http://www.scopus.com/inward/record.url?scp=85060217799&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85060217799&partnerID=8YFLogxK

U2 - 10.1007/s11912-019-0758-6

DO - 10.1007/s11912-019-0758-6

M3 - Review article

VL - 21

JO - Current Oncology Reports

JF - Current Oncology Reports

SN - 1523-3790

IS - 1

M1 - 5

ER -