Short- and long-term outcomes after large pulmonary resection for germ cell tumors after bleomycin-combination chemotherapy

Rafael S. Andrade, Kenneth Kesler, Jamison L. Wilson, Jo Ann Brooks, Brett D. Reichwage, Karen Rieger, Lawrence Einhorn, John Brown

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background Treatment of nonseminomatous germ cell tumors frequently requires bleomycin-combination chemotherapy followed by resection of residual disease. Bleomycin administration however raises concerns with respect to postoperative respiratory complications, particularly for patients undergoing large pulmonary resections. We undertook an institutional review to determine the outcome of large pulmonary resections after bleomycin-combination chemotherapy. Methods Between 1981 and 2001, 530 patients presented to our institution for resection of residual intrathoracic disease for either metastatic testicular or primary mediastinal nonseminomatous germ cell tumors. We subsequently reviewed 32 of these patients who required pneumonectomy (n = 19; right = 9, left = 10) or bilobectomy (n = 13) after bleomycin-combination chemotherapy. Results There were four operative deaths (13%). All postoperative deaths occurred in patients undergoing right-sided resections (pneumonectomy, n = 2; bilobectomy, n = 2) as a consequence of pulmonary complications. Operative survivors had a pulmonary morbidity of 18%. Fourteen of 20 long-term survivors were found to have a satisfactory performance status at follow-up. Conclusions Otherwise young and healthy male nonseminomatous germ cell tumors patients requiring large pulmonary resections after bleomycin-combination chemotherapy appear to be at higher than anticipated risk for pulmonary-related morbidity and mortality. However long-term survivors report an acceptable functional status.

Original languageEnglish
Pages (from-to)1224-1228
Number of pages5
JournalAnnals of Thoracic Surgery
Volume78
Issue number4
DOIs
StatePublished - Oct 2004

Fingerprint

Germ Cell and Embryonal Neoplasms
Bleomycin
Combination Drug Therapy
Lung
Survivors
Pneumonectomy
Morbidity
Patient Rights
Mortality
Nonseminomatous germ cell tumor

Keywords

  • 10

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Short- and long-term outcomes after large pulmonary resection for germ cell tumors after bleomycin-combination chemotherapy. / Andrade, Rafael S.; Kesler, Kenneth; Wilson, Jamison L.; Brooks, Jo Ann; Reichwage, Brett D.; Rieger, Karen; Einhorn, Lawrence; Brown, John.

In: Annals of Thoracic Surgery, Vol. 78, No. 4, 10.2004, p. 1224-1228.

Research output: Contribution to journalArticle

@article{5ca65adce669492996a29d23ddc39295,
title = "Short- and long-term outcomes after large pulmonary resection for germ cell tumors after bleomycin-combination chemotherapy",
abstract = "Background Treatment of nonseminomatous germ cell tumors frequently requires bleomycin-combination chemotherapy followed by resection of residual disease. Bleomycin administration however raises concerns with respect to postoperative respiratory complications, particularly for patients undergoing large pulmonary resections. We undertook an institutional review to determine the outcome of large pulmonary resections after bleomycin-combination chemotherapy. Methods Between 1981 and 2001, 530 patients presented to our institution for resection of residual intrathoracic disease for either metastatic testicular or primary mediastinal nonseminomatous germ cell tumors. We subsequently reviewed 32 of these patients who required pneumonectomy (n = 19; right = 9, left = 10) or bilobectomy (n = 13) after bleomycin-combination chemotherapy. Results There were four operative deaths (13{\%}). All postoperative deaths occurred in patients undergoing right-sided resections (pneumonectomy, n = 2; bilobectomy, n = 2) as a consequence of pulmonary complications. Operative survivors had a pulmonary morbidity of 18{\%}. Fourteen of 20 long-term survivors were found to have a satisfactory performance status at follow-up. Conclusions Otherwise young and healthy male nonseminomatous germ cell tumors patients requiring large pulmonary resections after bleomycin-combination chemotherapy appear to be at higher than anticipated risk for pulmonary-related morbidity and mortality. However long-term survivors report an acceptable functional status.",
keywords = "10",
author = "Andrade, {Rafael S.} and Kenneth Kesler and Wilson, {Jamison L.} and Brooks, {Jo Ann} and Reichwage, {Brett D.} and Karen Rieger and Lawrence Einhorn and John Brown",
year = "2004",
month = "10",
doi = "10.1016/j.athoracsur.2004.03.081",
language = "English",
volume = "78",
pages = "1224--1228",
journal = "Annals of Thoracic Surgery",
issn = "0003-4975",
publisher = "Elsevier USA",
number = "4",

}

TY - JOUR

T1 - Short- and long-term outcomes after large pulmonary resection for germ cell tumors after bleomycin-combination chemotherapy

AU - Andrade, Rafael S.

AU - Kesler, Kenneth

AU - Wilson, Jamison L.

AU - Brooks, Jo Ann

AU - Reichwage, Brett D.

AU - Rieger, Karen

AU - Einhorn, Lawrence

AU - Brown, John

PY - 2004/10

Y1 - 2004/10

N2 - Background Treatment of nonseminomatous germ cell tumors frequently requires bleomycin-combination chemotherapy followed by resection of residual disease. Bleomycin administration however raises concerns with respect to postoperative respiratory complications, particularly for patients undergoing large pulmonary resections. We undertook an institutional review to determine the outcome of large pulmonary resections after bleomycin-combination chemotherapy. Methods Between 1981 and 2001, 530 patients presented to our institution for resection of residual intrathoracic disease for either metastatic testicular or primary mediastinal nonseminomatous germ cell tumors. We subsequently reviewed 32 of these patients who required pneumonectomy (n = 19; right = 9, left = 10) or bilobectomy (n = 13) after bleomycin-combination chemotherapy. Results There were four operative deaths (13%). All postoperative deaths occurred in patients undergoing right-sided resections (pneumonectomy, n = 2; bilobectomy, n = 2) as a consequence of pulmonary complications. Operative survivors had a pulmonary morbidity of 18%. Fourteen of 20 long-term survivors were found to have a satisfactory performance status at follow-up. Conclusions Otherwise young and healthy male nonseminomatous germ cell tumors patients requiring large pulmonary resections after bleomycin-combination chemotherapy appear to be at higher than anticipated risk for pulmonary-related morbidity and mortality. However long-term survivors report an acceptable functional status.

AB - Background Treatment of nonseminomatous germ cell tumors frequently requires bleomycin-combination chemotherapy followed by resection of residual disease. Bleomycin administration however raises concerns with respect to postoperative respiratory complications, particularly for patients undergoing large pulmonary resections. We undertook an institutional review to determine the outcome of large pulmonary resections after bleomycin-combination chemotherapy. Methods Between 1981 and 2001, 530 patients presented to our institution for resection of residual intrathoracic disease for either metastatic testicular or primary mediastinal nonseminomatous germ cell tumors. We subsequently reviewed 32 of these patients who required pneumonectomy (n = 19; right = 9, left = 10) or bilobectomy (n = 13) after bleomycin-combination chemotherapy. Results There were four operative deaths (13%). All postoperative deaths occurred in patients undergoing right-sided resections (pneumonectomy, n = 2; bilobectomy, n = 2) as a consequence of pulmonary complications. Operative survivors had a pulmonary morbidity of 18%. Fourteen of 20 long-term survivors were found to have a satisfactory performance status at follow-up. Conclusions Otherwise young and healthy male nonseminomatous germ cell tumors patients requiring large pulmonary resections after bleomycin-combination chemotherapy appear to be at higher than anticipated risk for pulmonary-related morbidity and mortality. However long-term survivors report an acceptable functional status.

KW - 10

UR - http://www.scopus.com/inward/record.url?scp=4644225875&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=4644225875&partnerID=8YFLogxK

U2 - 10.1016/j.athoracsur.2004.03.081

DO - 10.1016/j.athoracsur.2004.03.081

M3 - Article

VL - 78

SP - 1224

EP - 1228

JO - Annals of Thoracic Surgery

JF - Annals of Thoracic Surgery

SN - 0003-4975

IS - 4

ER -