Tags

Type your tag names separated by a space and hit enter

Histological outcome of delayed orchidectomy after primary chemotherapy for metastatic germ cell tumour of the testis.
Clin Oncol (R Coll Radiol). 2008 Apr; 20(3):247-52.CO

Abstract

AIMS

To identify the incidence of viable local tumour in the testis of patients undergoing delayed orchidectomy after initial presentation with advanced germ cell tumour (GCT) treated by primary chemotherapy.

PATIENTS AND METHODS

Thirty-three patients presenting with advanced metastatic GCT were reviewed. The median age at presentation was 34 years. All received chemotherapy without previous orchidectomy. The decision to initiate chemotherapy without orchidectomy was based on a heavy tumour load and the patient's condition at initial presentation. A histological diagnosis was available from a biopsy of metastases in 23 patients; treatment in the remaining 10 patients was initiated after diagnosis based on a combination of elevated serum tumour markers, testicular findings and the presence of a retroperitoneal mass.

RESULTS

Seminomatous GCT (SGCT) was diagnosed in 13 patients, non-seminomatous GCT (NSGCT) in 17 patients and mixed GCT (MGCT) in the remaining three patients. Bleomycin/etoposide/cisplatin-based chemotherapy was the principle regimen. After initial chemotherapy, all patients with pure SGCT had only scar tissue in the orchidectomy specimen, with no residual tumour. Nine of 17 patients (52.9%) with NSGCT had viable tumour remaining in the orchidectomy specimen. All three cases of MGCT had persistent viable invasive seminoma. Twenty-seven patients (81.8%) were recurrence free and alive after a median of 49 months of follow-up.

CONCLUSIONS

Thirty-six per cent of patients had residual tumour locally in the testis after primary chemotherapy for metastatic GCT of the testis. However, in the cases with pure seminomatous disease, there was no residual tumour present. It may not be necessary to undertake delayed orchidectomy in these patients.

Authors+Show Affiliations

Christie Hospital NHS Foundation Trust, Manchester, UK.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18093814

Citation

Ramani, V A C., et al. "Histological Outcome of Delayed Orchidectomy After Primary Chemotherapy for Metastatic Germ Cell Tumour of the Testis." Clinical Oncology (Royal College of Radiologists (Great Britain)), vol. 20, no. 3, 2008, pp. 247-52.
Ramani VA, Grey BR, Addla SK, et al. Histological outcome of delayed orchidectomy after primary chemotherapy for metastatic germ cell tumour of the testis. Clin Oncol (R Coll Radiol). 2008;20(3):247-52.
Ramani, V. A., Grey, B. R., Addla, S. K., Dunham, M. P., Sangar, V. K., & Clarke, N. W. (2008). Histological outcome of delayed orchidectomy after primary chemotherapy for metastatic germ cell tumour of the testis. Clinical Oncology (Royal College of Radiologists (Great Britain)), 20(3), 247-52.
Ramani VA, et al. Histological Outcome of Delayed Orchidectomy After Primary Chemotherapy for Metastatic Germ Cell Tumour of the Testis. Clin Oncol (R Coll Radiol). 2008;20(3):247-52. PubMed PMID: 18093814.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Histological outcome of delayed orchidectomy after primary chemotherapy for metastatic germ cell tumour of the testis. AU - Ramani,V A C, AU - Grey,B R, AU - Addla,S K, AU - Dunham,M P, AU - Sangar,V K, AU - Clarke,N W, Y1 - 2008/02/21/ PY - 2007/06/28/received PY - 2007/10/31/revised PY - 2007/11/16/accepted PY - 2007/12/21/pubmed PY - 2008/9/25/medline PY - 2007/12/21/entrez SP - 247 EP - 52 JF - Clinical oncology (Royal College of Radiologists (Great Britain)) JO - Clin Oncol (R Coll Radiol) VL - 20 IS - 3 N2 - AIMS: To identify the incidence of viable local tumour in the testis of patients undergoing delayed orchidectomy after initial presentation with advanced germ cell tumour (GCT) treated by primary chemotherapy. PATIENTS AND METHODS: Thirty-three patients presenting with advanced metastatic GCT were reviewed. The median age at presentation was 34 years. All received chemotherapy without previous orchidectomy. The decision to initiate chemotherapy without orchidectomy was based on a heavy tumour load and the patient's condition at initial presentation. A histological diagnosis was available from a biopsy of metastases in 23 patients; treatment in the remaining 10 patients was initiated after diagnosis based on a combination of elevated serum tumour markers, testicular findings and the presence of a retroperitoneal mass. RESULTS: Seminomatous GCT (SGCT) was diagnosed in 13 patients, non-seminomatous GCT (NSGCT) in 17 patients and mixed GCT (MGCT) in the remaining three patients. Bleomycin/etoposide/cisplatin-based chemotherapy was the principle regimen. After initial chemotherapy, all patients with pure SGCT had only scar tissue in the orchidectomy specimen, with no residual tumour. Nine of 17 patients (52.9%) with NSGCT had viable tumour remaining in the orchidectomy specimen. All three cases of MGCT had persistent viable invasive seminoma. Twenty-seven patients (81.8%) were recurrence free and alive after a median of 49 months of follow-up. CONCLUSIONS: Thirty-six per cent of patients had residual tumour locally in the testis after primary chemotherapy for metastatic GCT of the testis. However, in the cases with pure seminomatous disease, there was no residual tumour present. It may not be necessary to undertake delayed orchidectomy in these patients. SN - 0936-6555 UR - https://www.unboundmedicine.com/medline/citation/18093814/Histological_outcome_of_delayed_orchidectomy_after_primary_chemotherapy_for_metastatic_germ_cell_tumour_of_the_testis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0936-6555(07)00887-4 DB - PRIME DP - Unbound Medicine ER -