کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
4275780 | 1611118 | 2007 | 7 صفحه PDF | دانلود رایگان |
Elevated serum tumor markers after cisplatin-based chemotherapy usually contraindicate surgery because of the presence of active germ-cell elements; however, some patients have undergone PCRPLND with curative intent. We evaluated the role of surgery to resect retroperitoneal-only marker positive tumor. Residual germ-cell cancer was identified in 50% of patients with elevated tumor markers with one third alive at 5 years; 5-year survival with residual teratoma or necrosis was 77.5% and 85.7%, respectively. Predictors of retroperitoneal teratoma or fibrosis included declining tumor makers at surgery, βHCG < 100, and first-line chemotherapy. Predictors of death included rising preoperative βHCG, elevated AFP, redo RPLND, and active germ-cell cancer in the resected specimen. Select patients with elevated tumor markers after chemotherapy are cured with surgery.
Journal: Urologic Clinics of North America - Volume 34, Issue 2, May 2007, Pages 219–225