Teratoma in the orchiectomy specimen and volume of metastasis are predictors of retroperitoneal teratoma in post-chemotherapy nonseminomatous testis cancer

Stephen D W Beck, Richard Foster, Richard Bihrle, Thomas Ulbright, Michael Koch, Gregory R. Wahle, Lawrence Einhorn, John P. Donohue

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Abstract

Purpose: Patients who require post-chemotherapy retroperitoneal lymph node dissection after induction chemotherapy for metastatic testis cancer derive therapeutic benefit from resection of teratoma but resection of necrosis is not beneficial. We determine if the absence of teratoma in the orchiectomy specimen is a reliable predictor of the absence of teratoma in the retroperitoneum at post-chemotherapy retroperitoneal lymph node dissection. Materials and Methods: A retrospective review of the Indiana University testis cancer data base was performed. A total of 644 patients who underwent retroperitoneal lymph node dissection after induction chemotherapy only were selected for study. The presence or absence of teratoma in the orchiectomy specimen and volume of retroperitoneal tumor were analyzed as predictors of retroperitoneal teratoma at post-chemotherapy retroperitoneal lymph node dissection. Results: Of the patients with teratoma in the orchiectomy specimen 85.6% had an element of teratoma in the retroperitoneum, and of those without teratomatous elements in the orchiectomy specimen 48% had teratoma in the retroperitoneum (p <0.00001). Increasing volumes of retroperitoneal tumor were associated with a higher probability of discovering teratoma at post-chemotherapy retroperitoneal lymph node dissection. Conclusions: The absence of teratoma in the orchiectomy specimen does not reliably predict the absence of teratoma in the surgical specimen at post-chemotherapy retroperitoneal lymph node dissection. Post-chemotherapy surgery is indicated if retroperitoneal tumor remains after chemotherapy irrespective of the presence or absence of teratoma in the orchiectomy specimen.

Original languageEnglish
Pages (from-to)1402-1404
Number of pages3
JournalJournal of Urology
Volume168
Issue number4 I
StatePublished - Oct 2002

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Orchiectomy
Teratoma
Testicular Neoplasms
Neoplasm Metastasis
Drug Therapy
Lymph Node Excision
Induction Chemotherapy
Tumor Burden
Necrosis
Databases

Keywords

  • Teratoma, lymph node excision
  • Testicular neoplasms

ASJC Scopus subject areas

  • Urology

Cite this

@article{ae2c54a788b94833b4b1c9284646049f,
title = "Teratoma in the orchiectomy specimen and volume of metastasis are predictors of retroperitoneal teratoma in post-chemotherapy nonseminomatous testis cancer",
abstract = "Purpose: Patients who require post-chemotherapy retroperitoneal lymph node dissection after induction chemotherapy for metastatic testis cancer derive therapeutic benefit from resection of teratoma but resection of necrosis is not beneficial. We determine if the absence of teratoma in the orchiectomy specimen is a reliable predictor of the absence of teratoma in the retroperitoneum at post-chemotherapy retroperitoneal lymph node dissection. Materials and Methods: A retrospective review of the Indiana University testis cancer data base was performed. A total of 644 patients who underwent retroperitoneal lymph node dissection after induction chemotherapy only were selected for study. The presence or absence of teratoma in the orchiectomy specimen and volume of retroperitoneal tumor were analyzed as predictors of retroperitoneal teratoma at post-chemotherapy retroperitoneal lymph node dissection. Results: Of the patients with teratoma in the orchiectomy specimen 85.6{\%} had an element of teratoma in the retroperitoneum, and of those without teratomatous elements in the orchiectomy specimen 48{\%} had teratoma in the retroperitoneum (p <0.00001). Increasing volumes of retroperitoneal tumor were associated with a higher probability of discovering teratoma at post-chemotherapy retroperitoneal lymph node dissection. Conclusions: The absence of teratoma in the orchiectomy specimen does not reliably predict the absence of teratoma in the surgical specimen at post-chemotherapy retroperitoneal lymph node dissection. Post-chemotherapy surgery is indicated if retroperitoneal tumor remains after chemotherapy irrespective of the presence or absence of teratoma in the orchiectomy specimen.",
keywords = "Teratoma, lymph node excision, Testicular neoplasms",
author = "Beck, {Stephen D W} and Richard Foster and Richard Bihrle and Thomas Ulbright and Michael Koch and Wahle, {Gregory R.} and Lawrence Einhorn and Donohue, {John P.}",
year = "2002",
month = "10",
language = "English",
volume = "168",
pages = "1402--1404",
journal = "Journal of Urology",
issn = "0022-5347",
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number = "4 I",

}

TY - JOUR

T1 - Teratoma in the orchiectomy specimen and volume of metastasis are predictors of retroperitoneal teratoma in post-chemotherapy nonseminomatous testis cancer

AU - Beck, Stephen D W

AU - Foster, Richard

AU - Bihrle, Richard

AU - Ulbright, Thomas

AU - Koch, Michael

AU - Wahle, Gregory R.

AU - Einhorn, Lawrence

AU - Donohue, John P.

PY - 2002/10

Y1 - 2002/10

N2 - Purpose: Patients who require post-chemotherapy retroperitoneal lymph node dissection after induction chemotherapy for metastatic testis cancer derive therapeutic benefit from resection of teratoma but resection of necrosis is not beneficial. We determine if the absence of teratoma in the orchiectomy specimen is a reliable predictor of the absence of teratoma in the retroperitoneum at post-chemotherapy retroperitoneal lymph node dissection. Materials and Methods: A retrospective review of the Indiana University testis cancer data base was performed. A total of 644 patients who underwent retroperitoneal lymph node dissection after induction chemotherapy only were selected for study. The presence or absence of teratoma in the orchiectomy specimen and volume of retroperitoneal tumor were analyzed as predictors of retroperitoneal teratoma at post-chemotherapy retroperitoneal lymph node dissection. Results: Of the patients with teratoma in the orchiectomy specimen 85.6% had an element of teratoma in the retroperitoneum, and of those without teratomatous elements in the orchiectomy specimen 48% had teratoma in the retroperitoneum (p <0.00001). Increasing volumes of retroperitoneal tumor were associated with a higher probability of discovering teratoma at post-chemotherapy retroperitoneal lymph node dissection. Conclusions: The absence of teratoma in the orchiectomy specimen does not reliably predict the absence of teratoma in the surgical specimen at post-chemotherapy retroperitoneal lymph node dissection. Post-chemotherapy surgery is indicated if retroperitoneal tumor remains after chemotherapy irrespective of the presence or absence of teratoma in the orchiectomy specimen.

AB - Purpose: Patients who require post-chemotherapy retroperitoneal lymph node dissection after induction chemotherapy for metastatic testis cancer derive therapeutic benefit from resection of teratoma but resection of necrosis is not beneficial. We determine if the absence of teratoma in the orchiectomy specimen is a reliable predictor of the absence of teratoma in the retroperitoneum at post-chemotherapy retroperitoneal lymph node dissection. Materials and Methods: A retrospective review of the Indiana University testis cancer data base was performed. A total of 644 patients who underwent retroperitoneal lymph node dissection after induction chemotherapy only were selected for study. The presence or absence of teratoma in the orchiectomy specimen and volume of retroperitoneal tumor were analyzed as predictors of retroperitoneal teratoma at post-chemotherapy retroperitoneal lymph node dissection. Results: Of the patients with teratoma in the orchiectomy specimen 85.6% had an element of teratoma in the retroperitoneum, and of those without teratomatous elements in the orchiectomy specimen 48% had teratoma in the retroperitoneum (p <0.00001). Increasing volumes of retroperitoneal tumor were associated with a higher probability of discovering teratoma at post-chemotherapy retroperitoneal lymph node dissection. Conclusions: The absence of teratoma in the orchiectomy specimen does not reliably predict the absence of teratoma in the surgical specimen at post-chemotherapy retroperitoneal lymph node dissection. Post-chemotherapy surgery is indicated if retroperitoneal tumor remains after chemotherapy irrespective of the presence or absence of teratoma in the orchiectomy specimen.

KW - Teratoma, lymph node excision

KW - Testicular neoplasms

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M3 - Article

VL - 168

SP - 1402

EP - 1404

JO - Journal of Urology

JF - Journal of Urology

SN - 0022-5347

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