Role of chemotherapy and surgery in the treatment of thoracic metastases from nonseminomatous germ cell testis tumor Academic Article Article uri icon

Overview

MeSH Major

  • Dendritic Cells
  • Immunotherapy

abstract

  • The role of chemotherapy and of surgery in the management of pulmonary metastases from nonseminomatous germ cell tumors (NSGCT) has been analyzed. Thoracic metastases were classified as minimal, if the diameter of the largest was 2 cm or less and five or fewer nodules were present in each lung, and advanced if any metastasis was over 2 cm in diameter and/or six or more nodules were present in either lung field, and/or mediastinal disease, hilar metastasis or pleural effusion was present. Complete thoracic remission (CR) with chemotherapy alone occurred in 49/67 (73%) patients, 86% with minimal and 68% with advanced disease. Absence of concomitant retroperitoneal metastases at the beginning of chemotherapy was associated with better prognosis than when retroperitoneal metastases were present (CR 85% vs 68%, respectively). The histologic type of testis tumors did not influence CR rates of pulmonary metastases. Approximately one half of patients with clinical evidence of retroperitoneal metastases at the beginning of chemotherapy achieving pulmonary CR with chemotherapy alone had clinical evidence of retroperitoneal disease after chemotherapy. Six patients had thoracotomy to document CR to chemotherapy by resection of necrotic tissue. Six patients had thoracotomy to achieve CR by resection of residual neoplasm. The keys to success were a favorable response to chemotherapy and complete resection of any residual tumor. Considering all stages of NSGCT and provided no adjuvant chemotherapy was given, thoracic surgery will be responsible for elimination of thoracic metastases in an estimated 2–5% of patients after adequate chemotherapy. Such intervention is curative in patients with pulmonary metastases only but in those with concomitant retroperitoneal metastases, the final outcome will frequently be decided by the response to chemotherapy and/or the resectability of retroperitoneal metastatic deposits. Copyright © 1982 American Cancer Society

publication date

  • January 1982

Research

keywords

  • Academic Article

Identity

Digital Object Identifier (DOI)

  • 10.1002/1097-0142(19820915)50:6<1057::AID-CNCR2820500606>3.0.CO;2-C

PubMed ID

  • 6286083

Additional Document Info

start page

  • 1057

end page

  • 60

volume

  • 50

number

  • 6