Complex treatment of residual metastatic germ cell cancer A single center experience /

Testicular cancer is the most common solid malignancy among men aged 15-35. Radical orchiectomy and platinum-based chemotherapy (BEP) are curative in the majority of patients, including advanced, metastatic cases. According to current urooncology guidelines all non-seminoma patients harbouring post-...

Teljes leírás

Elmentve itt :
Bibliográfiai részletek
Szerzők: Fazekas Fruzsina
Újfaludi Zsuzsanna
Bíró Krisztina
Páhi Zoltán Gábor
Buzogány István
Sükösd Farkas
Pankotai Tibor
Beöthe Tamás
Dokumentumtípus: Cikk
Megjelent: 2024
Sorozat:JOURNAL OF BIOTECHNOLOGY 389
Tárgyszavak:
doi:10.1016/j.jbiotec.2024.04.018

mtmt:34839173
Online Access:http://publicatio.bibl.u-szeged.hu/33528
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520 3 |a Testicular cancer is the most common solid malignancy among men aged 15-35. Radical orchiectomy and platinum-based chemotherapy (BEP) are curative in the majority of patients, including advanced, metastatic cases. According to current urooncology guidelines all non-seminoma patients harbouring post-chemotherapy residual masses of ≥ 1cm should undergo salvage retroperitoneal lymph node dissection (RPLND). However, only 10% of residual tumors contain viable disease.To assess patient outcomes and complications considering different treatment regimens and clinical characteristics.In a retrospective cross-sectional study patients (n=127) who underwent postchemotherapy RPLND between 2007 and 2023 at our referral center were evaluated. The patients received systemic treatment at various oncology centers. The number of BEP cycles received were occasionally different from standard. Only patients with normal postchemotherapy serum tumor markers and primary testicular or extragonadal germ cell neoplasms were included. Treatment groups were established according to the number of BEP cycles received, and the extent of RPLND (bilateral or modified template). Treatment outcomes and complications were assessed.Standard 3-4 courses of BEP were received by 100 (78,7%) patients, while 11 (8,7%) patients underwent less, and 16 (12,6%) more courses than standard. On histopathologic evaluation viable germ cell tumor, teratoma, and necrosis/fibrosis was present in 26 (20,5%), 67 (52,7%) and 34 (26,8%) of specimen, respectively. In the 5-6 BEP series subgroup high rate of viable disease (37,5%) was found and significantly more nephrectomies were performed, than other chemotherapy subgroups. Extratesticular GCT, viable disease in residual mass or progression after RPLND indicated lower survival. Mild (Clavien-Dindo I-II) or no postoperative complications were reported in 93,7% of cases.The study suggests no significant benefit from exceeding 3-4 courses of BEP. Timely salvage RPLND should be performed in high volume centers for optimal treatment outcomes with acceptable complication rates. Adherence to the Heidenreich criteria is advisable where practical. 
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700 0 1 |a Bíró Krisztina  |e aut 
700 0 1 |a Páhi Zoltán Gábor  |e aut 
700 0 1 |a Buzogány István  |e aut 
700 0 1 |a Sükösd Farkas  |e aut 
700 0 1 |a Pankotai Tibor  |e aut 
700 0 1 |a Beöthe Tamás  |e aut 
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