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Risk of Recurrence for Clinical Stage I and II Patients With Teratoma Only at Primary Retroperitoneal Lymph Node Dissection.

AbstractOBJECTIVE:
To evaluate the oncologic outcomes of patients with retroperitoneal teratoma only at primary retroperitoneal lymph node dissection (RPLND) who did not receive adjuvant chemotherapy.
MATERIALS AND METHODS:
Between 1979 and 2010, 23 patients with clinical stage (CS) I and II disease underwent primary RPLND at our institution with teratoma only in the retroperitoneum. No patient received adjuvant chemotherapy and the minimum follow-up was 2 years.
RESULTS:
At the initial diagnosis, 13 patients (56.5%) had CS I disease and 10 patients (43.5%) had CS II disease. Pathologic staging demonstrated IIA in 13 patients (56.5%), IIB in 8 patients (34.8%), and IIC in 2 patients (8.7%). The 5-year disease-free survival (DFS) was 100% with a median follow-up of 5.8 years (range, 2.1-25.4). DFS was not significantly different comparing pathologic stage IIA vs IIB/IIC disease (P = .73). Two patients (14%) developed late relapses. One patient had a pelvic recurrence 11 years after primary RPLND. Final pathology from the pelvic resection demonstrated embryonal carcinoma. He remains disease free after his second surgery. The second patient had a contralateral retroperitoneal recurrence with yolk-sac tumor and teratoma 11 years after primary RPLND. He was treated with chemotherapy followed by postchemotherapy RPLND.
CONCLUSION:
The relapse rate for patients with teratoma only at primary RPLND is low irrespective of PS. Adjuvant chemotherapy is therefore not recommended in the management of these patients.
AuthorsNick W Liu, Clint Cary, Andrew C Strine, Stephen D W Beck, Timothy A Masterson, Richard Bihrle, Richard S Foster
JournalUrology (Urology) Vol. 86 Issue 5 Pg. 981-4 (Nov 2015) ISSN: 1527-9995 [Electronic] United States
PMID26232690 (Publication Type: Journal Article)
CopyrightCopyright © 2015 Elsevier Inc. All rights reserved.
Topics
  • Adolescent
  • Adult
  • Age Factors
  • Databases, Factual
  • Disease-Free Survival
  • Follow-Up Studies
  • Humans
  • Kaplan-Meier Estimate
  • Lymph Node Excision (methods)
  • Lymph Nodes (pathology, surgery)
  • Male
  • Neoplasm Invasiveness (pathology)
  • Neoplasm Recurrence, Local (drug therapy, epidemiology, pathology)
  • Neoplasm Staging
  • Retroperitoneal Space (surgery)
  • Retrospective Studies
  • Risk Assessment
  • Statistics, Nonparametric
  • Survival Rate
  • Teratoma (mortality, pathology, surgery)
  • Testicular Neoplasms (mortality, pathology, surgery)
  • Treatment Outcome
  • Young Adult

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