Post-chemotherapy retroperitoneal teratoma in nonseminomatous germ cell tumors: Do predictive factors exist? Results from a national multicenter study

J Surg Oncol. 2016 Dec;114(8):992-996. doi: 10.1002/jso.24464. Epub 2016 Nov 18.

Abstract

Background and objectives: To identify predictive preoperative factors of the presence of teratoma in retroperitoneal lymph node dissection specimens.

Methods: We performed a 20 years multicenter retrospective analysis of all patients who underwent retroperitoneal lymph node dissection for residual masses after chemotherapy (PC-RPLND). Patients had undergone PC-RPLND after chemotherapy for advanced testicular cancer. The histologic components of the primary tumor were compared with those of the residual masses using logistic regression.

Results: A total of 469 NSGCT patients underwent PC-RPLND (complete data available for 211). By PC-RPLND, necrosis was found in 84 cases, teratoma in 102 cases, and viable tumor in 25 cases. The univariate and multivariate analyses showed that teratoma (P = 0.001 and P = 0.002, respectively) and yolk sac tumor (P = 0.009 and P = 0.035, respectively) in orchiectomy specimens were statistically significant predictors of the presence of teratoma in retroperitoneal lymph nodes.

Conclusions: PC-RPLND is the standard treatment for any supracentimetric residual lesion. This procedure is associated with a high morbidity, and almost half patients are overtreated. The presence of teratoma and yolk sac tumor in the orchiectomy specimen were independent significant predictors of teratoma in retroperitoneal masses. J. Surg. Oncol. 2016;114:992-996. © 2016 Wiley Periodicals, Inc.

Keywords: chemotherapy; retroperitoneal lymph node dissection; teratoma; testicular neoplasm.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Antineoplastic Agents / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Chemotherapy, Adjuvant
  • Cisplatin / therapeutic use
  • Humans
  • Logistic Models
  • Lymph Node Excision*
  • Lymph Nodes / pathology*
  • Lymph Nodes / surgery
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Neoplasms, Germ Cell and Embryonal / drug therapy
  • Neoplasms, Germ Cell and Embryonal / pathology*
  • Neoplasms, Germ Cell and Embryonal / surgery
  • Orchiectomy
  • Retroperitoneal Neoplasms / etiology
  • Retroperitoneal Neoplasms / pathology*
  • Retroperitoneal Neoplasms / surgery
  • Retroperitoneal Space
  • Retrospective Studies
  • Risk Factors
  • Teratoma / pathology*
  • Teratoma / surgery
  • Testicular Neoplasms / drug therapy
  • Testicular Neoplasms / pathology*
  • Testicular Neoplasms / surgery
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Cisplatin

Supplementary concepts

  • Nonseminomatous germ cell tumor