Affordable Access

deepdyve-link
Publisher Website

Determination of risk factors for progression in patients with viable tumor at post-chemotherapy lymph node dissection due to disseminated non-seminomatous germ-cell tumors.

Authors
  • Altan, Mesut1
  • Haberal, Hakan Bahadır2
  • Aşçı, Ahmet2
  • Güdeloğlu, Ahmet2
  • Doğrul, Ahmet Bülent3
  • Yazıcı, Mustafa Sertaç2
  • Akdoğan, Bülent2
  • Özen, Haluk2
  • 1 Department of Urology, Hacettepe University School of Medicine, 06230, Ankara, Turkey. [email protected] , (Turkey)
  • 2 Department of Urology, Hacettepe University School of Medicine, 06230, Ankara, Turkey. , (Turkey)
  • 3 Department of General Surgery, Hacettepe University School of Medicine, Ankara, Turkey. , (Turkey)
Type
Published Article
Journal
International journal of clinical oncology
Publication Date
Jan 01, 2021
Volume
26
Issue
1
Pages
186–191
Identifiers
DOI: 10.1007/s10147-020-01786-8
PMID: 32960421
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

To assess the clinical variables that effect progression in patients with viable tumor after post-chemotherapy lymph node dissection due to disseminated non-seminomatous germ-cell tumors. We performed a retrospective analysis of 32 patients with viable tumor after PC-RPLND, operated between 1990 and 2016. Patients were categorized into 2 groups as favorable and non-favorable (intermedia and poor) according to International Germ Cell Consensus Classification (IGCCC). Tumor size was determined as the largest dimension of retroperitoneal mass. Clinical factors and adjuvant chemotherapy were evaluated to impact on recurrence free survival (RFS) and overall survival (OS). The median age of the patients and follow-up duration were 28.5 (17-51) years and 51.5 (4-253) months, respectively. 5-year RFS and OS were 57.8-66.8%, respectively. On univariate analysis, percentage of viable tumor, IGCCC risk group, primary site, second-line chemotherapy and surgical margin status were significant for RFS (p = 0.034, p = 0.002, p < 0.001, p = 0.011 and p < 0.001, respectively), while IGCCC risk group, second-line chemotherapy and surgical margin status were significant for OS (p = 0.004, p = 0.010 and p < 0.001, respectively). On multivariate analysis, second-line chemotherapy and surgical margin were independent risk factors for RFS (p = 0.016, HR 4.927 95% CI 1.34-18.02 and p < 0.001, OR 9.147 95% CI 2.61-31.98, respectively) and surgical margin status was the only predictor of OS (p = 0.038, HR 3.874 95% CI 1.07-13.69). Retroperitoneal lymph node dissection with negative surgical margin is essential for patients with viable residual tumor after chemotherapy. Need for second-line chemotherapy shows risk of progression.

Report this publication

Statistics

Seen <100 times