830 PATHOHISTOLOGICAL FINDINGS IN PATIENTS WITH NONSEMINOMATOUS GERM CELL TUMOURS (NSGCT) WHO UNDERGO POSTCHEMOTHERAPY RETROPERITONEAL LYMPH NODE DISSECTION (PC-RPLND) FOR SMALL TUMOURS

Abstract

You have accessJournal of UrologyPenis/Testis/Urethra: Benign & Malignant Disease1 Apr 2011830 PATHOHISTOLOGICAL FINDINGS IN PATIENTS WITH NONSEMINOMATOUS GERM CELL TUMOURS (NSGCT) WHO UNDERGO POSTCHEMOTHERAPY RETROPERITONEAL LYMPH NODE DISSECTION (PC-RPLND) FOR SMALL TUMOURS David Pfister, Jonas Busch, Christian Winter, Peter Albers, Mark Schrader, Klaus-Peter Dieckmann, Susanne Krege, Hans Schmelz, and Axel Heidenreich David PfisterDavid Pfister Aachen, Germany More articles by this author , Jonas BuschJonas Busch Berlin, Germany More articles by this author , Christian WinterChristian Winter Düsseldorf, Germany More articles by this author , Peter AlbersPeter Albers Düsseldorf, Germany More articles by this author , Mark SchraderMark Schrader Ulm, Germany More articles by this author , Klaus-Peter DieckmannKlaus-Peter Dieckmann Hamburg, Germany More articles by this author , Susanne KregeSusanne Krege Krefeld, Germany More articles by this author , Hans SchmelzHans Schmelz Koblenz, Germany More articles by this author , and Axel HeidenreichAxel Heidenreich Aachen, Germany More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.650AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The current guidelines recommend the resection of all visible residual tumours in NSGCT after a cisplatin based chemotherapy. There are controversial data concerning the necessity of PC-RPLND in patients with residual tumours less than one centimetre in diameter. The aim of our study was to evaluate the pathological findings in a modern series with regard of the residual tumour size. METHODS A retrospective analysis of the patient′s charts was performed including patients who underwent PC-RPLND between 1989 and 2010. Of 408 patients 330 had a NSGCT, 78 patients had a pure seminoma or a primary extragonadal germ cell cancer and were excluded from analysis. The tumour size at the time of surgery was available in 261 patients in the remaining 69 pateints no preopretive data with regard to the tumour size were recorded in the radiology reports. Due to the location of the residual tumour a median laparotomy, a thoracoabdominal approach was used. In one center a laparoscopic approach was preferred. RESULTS Mean tumour diameter was 4.7 (0 to 32) cm. The patients were stratified in three groups: group 1 n=28 (RT<=1cm), group 2 n=23 (RT>1<=1,5cm) and group 3 n=209 (RT>1.5cm). The histological specimens contained teratoma in 21,4%, 39,1%, 44,5% respectively, viable cancer in 10,7%, 17,4% and 22% respectively, and fibrosis/necrosis in 64,3%, 52,2% and 37,8% respectively in the three groups respectively. CONCLUSIONS The finding of both teratoma and viable cancer decreases with decreasing sizes of the residual tumour. Nevertheless lesions <= than 1 cm still harbour a significant pathohistology in one third of the patients. As a consequence PC-RPLND must not be omitted even in small RT. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e334 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information David Pfister Aachen, Germany More articles by this author Jonas Busch Berlin, Germany More articles by this author Christian Winter Düsseldorf, Germany More articles by this author Peter Albers Düsseldorf, Germany More articles by this author Mark Schrader Ulm, Germany More articles by this author Klaus-Peter Dieckmann Hamburg, Germany More articles by this author Susanne Krege Krefeld, Germany More articles by this author Hans Schmelz Koblenz, Germany More articles by this author Axel Heidenreich Aachen, Germany More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...