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Is retroperitoneal histology predictive of liver histology at concurrent post-chemotherapy retroperitoneal lymph node dissection and hepatic resection?

AbstractPURPOSE:
We identified factors predicting liver histology in patients with nonseminomatous germ cell tumor undergoing concurrent post-chemotherapy retroperitoneal lymph node dissection and liver resection.
MATERIALS AND METHODS:
We reviewed the Indiana University testis cancer database to identify all patients with nonseminomatous germ cell tumor and liver metastasis who underwent post-chemotherapy retroperitoneal lymph node dissection and liver resection between 1976 and 2006.
RESULTS:
A total of 59 patients met study inclusion criteria. Necrosis, teratoma and cancer were identified in 31%, 46% and 24% of retroperitoneal specimens, and in 73%, 17% and 10% of liver specimens, respectively. Concordance between retroperitoneal and liver histology was 49% overall, including 94% for necrosis, 26% for teratoma and 36% for cancer. Liver necrosis alone was found in 94%, 70% and 50% of patients with retroperitoneal necrosis, teratoma and cancer, respectively.
CONCLUSIONS:
The overall rate of histological discordance between retroperitoneal and liver histology was 51% with 73% of all liver specimens containing necrosis only. Retroperitoneal necrosis is highly predictive of hepatic necrosis (94%). Management for liver lesions at post-chemotherapy retroperitoneal lymph node dissection must be individualized. Observation may be warranted for liver lesions requiring complicated hepatic surgery regardless of retroperitoneal pathology.
AuthorsNiels-Erik B Jacobsen, Stephen D W Beck, Lewis E Jacobson, Richard Bihrle, Lawrence H Einhorn, Richard S Foster
JournalThe Journal of urology (J Urol) Vol. 184 Issue 3 Pg. 949-53 (Sep 2010) ISSN: 1527-3792 [Electronic] United States
PMID20643453 (Publication Type: Journal Article)
Copyright2010 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
Topics
  • Adolescent
  • Adult
  • Child
  • Hepatectomy
  • Humans
  • Liver (pathology)
  • Liver Neoplasms (secondary, surgery)
  • Lymph Node Excision (methods)
  • Male
  • Necrosis
  • Neoplasms, Germ Cell and Embryonal (drug therapy, secondary, surgery)
  • Predictive Value of Tests
  • Retroperitoneal Space
  • Retrospective Studies
  • Testicular Neoplasms (drug therapy, surgery)
  • Time Factors
  • Young Adult

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