Pulmonary metastasectomy following chemotherapy in patients with testicular tumors: experience in 52 patients

Thorac Cardiovasc Surg. 2006 Oct;54(7):484-8. doi: 10.1055/s-2006-924246.

Abstract

Background: Surgical resection is an important form of treatment for residual post-chemotherapy pulmonary masses in patients with non-seminomatous germ cell tumors. We analyzed the outcome and prognostic factors after surgery.

Methods: Between 1996 and 2001, 52 patients underwent pulmonary resection of thoracic masses following cisplatin-based chemotherapy. These patients' records were subsequently reviewed.

Results: The overall 5-year survival rate was 75.8 %. A significantly longer survival was observed using multivariate analysis in patients with normal serum AFP and/or hCG tumor marker levels and after complete surgical resection. In patients with viable malignant tumor cells in the resected specimen and in patients with only necrosis/fibrosis or teratoma, the 5-year survival rates were 49.6 % and 82.8 %, respectively. This difference was only statistically significant in univariate analysis.

Conclusions: We conclude that pulmonary resection in metastatic non-seminomatous germ cell tumors is a safe and effective treatment modality. Incomplete resection and elevated tumor marker levels, AFP and/or hCG, were identified as prognosis-related criteria for a poor outcome in multivariate analysis.

MeSH terms

  • Adolescent
  • Adult
  • Humans
  • Lung Neoplasms / pathology
  • Lung Neoplasms / secondary*
  • Lung Neoplasms / surgery*
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm, Residual / surgery
  • Neoplasms, Germ Cell and Embryonal / pathology
  • Neoplasms, Germ Cell and Embryonal / secondary*
  • Neoplasms, Germ Cell and Embryonal / surgery*
  • Proportional Hazards Models
  • Retrospective Studies
  • Survival Analysis
  • Testicular Neoplasms / pathology*