Abstract | OBJECTIVE: To evaluate whether an aggressive surgical policy, which included vascular surgery with standard retroperitoneal lymph node dissection (RPLND), would be justified for managing bulky retroperitoneal growing teratoma syndrome (GTS). METHODS: Data were collected retrospectively from a series of 12 patients who, from 1992 to 2010, underwent radical RPLND for bulky GTS (retroperitoneal mass≥10 cm in diameter). For complete resection, vascular procedures and nephrectomy were performed. RESULTS: Median tumor diameter was 100 mm before and 140 mm (range 100-300) after chemotherapy. Two patients underwent iterative RPLND. In addition to RPLND, patients underwent aortic section with aortic anastomosis (n=6), inferior vena cava resection (n=3), both the latter and the former (n=1), and aortic graft with left nephrectomy (n=2). There were no operative deaths; 3 patients had complications (25%), but none were related to extended procedures. The median hospital stay was 15 days. Median follow up was 59 months (range 10-162). One patient died of metastatic cutaneous melanoma 112 months after RPLND, 10 patients survived and are disease-free, and one patient had a para-aortic recurrence. CONCLUSION: A 100% complete resection rate, long-term survival, no mortality, and acceptable morbidity were achieved when vascular surgery and left nephrectomy were combined with standard RPLND for bulky GTS.
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Authors | Mattia Stella, Alessandro Gandini, Pierre Meeus, Ivan Aleksic, Aude Flechon, Claire Cropet, Jean Pierre Droz, Michel Rivoire |
Journal | Urology
(Urology)
Vol. 79
Issue 2
Pg. 365-70
(Feb 2012)
ISSN: 1527-9995 [Electronic] United States |
PMID | 22173179
(Publication Type: Evaluation Study, Journal Article)
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Copyright | Copyright © 2012 Elsevier Inc. All rights reserved. |
Chemical References |
- Biomarkers, Tumor
- Bleomycin
- Etoposide
- Cisplatin
|
Topics |
- Adult
- Anastomosis, Surgical
- Antineoplastic Combined Chemotherapy Protocols
(therapeutic use)
- Aorta, Abdominal
(surgery)
- Biomarkers, Tumor
(blood)
- Bleomycin
(administration & dosage)
- Blood Vessel Prosthesis Implantation
- Cisplatin
(administration & dosage)
- Combined Modality Therapy
- Etoposide
(administration & dosage)
- Humans
- Lymph Node Excision
- Male
- Nephrectomy
- Retroperitoneal Neoplasms
(blood supply, drug therapy, secondary, surgery)
- Retrospective Studies
- Teratoma
(blood supply, drug therapy, pathology, secondary, surgery)
- Testicular Neoplasms
(surgery)
- Tumor Burden
- Vascular Surgical Procedures
(methods, statistics & numerical data)
- Vena Cava, Inferior
(surgery)
- Young Adult
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