Abstract
Objective
To compare a simultaneous vs sequential approach to residual post chemotherapy mass
resections in metastatic testis cancer.
Methods
A retrospective review was performed of patients who underwent retroperitoneal and
thoracic/cervical resection of post chemotherapy residual masses between 2002 and
2018. Group 1: “Simultaneous” (Combined Retroperitoneal and Thoracic/Cervical resections
on the same date); Group 2: “Sequential” (Retroperitoneal and Thoracic/Cervical resections
at separate dates).
Results
During the study period, 35 simultaneous and 17 sequential resections were performed.
The median age at surgery was 28 years (Range 16-61). The median follow-up from last
surgical procedure was 62.7 months (Range 0.4-194). Histology revealed teratoma in
38 (73.1%) patients, necrosis in 8 (15.4%) and viable tumor in 6 (11.5%). Discordant
pathology findings between thoracic/cervical and abdominal resections were noted in
16 (30.8%) patients.
No differences were observed between the simultaneous vs sequential groups in median
operating time (585 minutes vs 545 minutes, P = .64), blood loss (1300 vs 1300 mls, P = .42), or length of stay (9 vs 11 days, P = .14). There was no difference between the 5-year (65.7% vs 68.6%) relapse-free
survival between the 2 groups (P = .84) or the 5-year (88.6% vs 100%) overall and disease-specific survival (P = .25).
Conclusion
Simultaneous resection of retroperitoneal and thoracic/cervical post chemotherapy
metastases is a feasible in some patients. It requires multidisciplinary collaboration
and a longer primary procedure.
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Article info
Publication history
Published online: January 28, 2020
Accepted:
December 10,
2019
Received:
October 25,
2019
Footnotes
Funding: None.
Conflicts of Interest: Gregory Nason, Laura Donahoe, Ishan Aditya, Marc de Perrot, Michael Jewett, Padraig Warde, Peter Chung, Lynn Anson-Cartwright, Aaron Hansen, Philip Bedard, Martin O'Malley, Joan Sweet, Eshetu Atenafu—None.
Robert Hamilton—Advisory Board—Bayer, Amgen, Janssen, Astellas; Research Funding—Bayer (ARASENS trial), Janssen (SPARTAN trial); Speaking Honoraria—Abbvie; Meeting Travel—Roche.
Identification
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