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CC BY-NC-ND 4.0 · Revista Urología Colombiana / Colombian Urology Journal 2020; 29(04): 235-239
DOI: 10.1055/s-0040-1721357
Original Article | Artículo Original
Oncological Urology/Urología Oncológica

Factores asociados a la histología de masa residual retroperitoneal post quimioterapia en tumor testicular de células germinales

Factors Associated with the Histology of Retroperitoneal Residual Mass Post Chemotherapy in Testicular Germ Cell Tumor
Lynda Torres 
1   Médica Uróloga. Pontificia Universidad Javeriana, Bogotá, Colombia
,
Jose Gustavo Ramos
2   Médico Urólogo, Urología Oncológica, Instituto Nacional de Cancerología, Bogotá, Colombia
,
Rodolfo Varela
2   Médico Urólogo, Urología Oncológica, Instituto Nacional de Cancerología, Bogotá, Colombia
,
Fabian Godoy
2   Médico Urólogo, Urología Oncológica, Instituto Nacional de Cancerología, Bogotá, Colombia
,
Paola Andrea Orrego
3   Médica residente, Universidad Militar Nueva Granada, Bogotá, Colombia
,
AysaVanessa Mosquera
3   Médica residente, Universidad Militar Nueva Granada, Bogotá, Colombia
,
Sandra Viviana Pulido Vecino
3   Médica residente, Universidad Militar Nueva Granada, Bogotá, Colombia
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Resumen

Objetivo El objetivo de este estudio es describir las características y factores relacionados con la histología de la masa residual postquimioterapia en pacientes con tumor de células germinales de origen testicular sometidos a linfadenectomía retroperitoneal durante 12 años de seguimiento.

Métodos Retrospectivamente se recolectaron datos clínicos, quirúrgicos y patológicos de la historia clínica de los pacientes en un centro de referencia de manejo de cáncer durante un periodo de 12 años. Se estimó la asociación entre los datos recolectados con la histología del tumor residual post quimioterapia.

Resultados Se incluyeron 64 pacientes, la edad promedio fue 28.1 años, el tamaño promedio de masa residual fue de 6.7 cm. La histología de la masa residual fue teratoma en 60.9%, necrosis 26.5% y tumor viable 12.5%. El grupo pronóstico tiene asociación con la histología de la masa retroperitoneal. Las masas con histología de necrosis tuvieron menor tamaño con media 6.5 cm mientras que otras histologías tuvieron tamaño promedio de la masa residual de 10.4 cm.

Conclusiones La LNDRP-PC es el estándar de tratamiento en masas residuales retroperitoneales después de quimioterapia y puede generar sobre-tratamiento hasta en 50% de los casos. El teratoma en la histología testicular está relacionado mayor tamaño de la masa residual retroperitoneal. Las características histológicas de la masa residual son comparables con otras series.

Abstract

Objective The aim of the study is to describe factors and characteristics related with the post-chemotherapy residual mass histology in patients who undergoing RPLND.

Methods Clinical, surgical and pathological data were retrospectively recorded from medical records of patients with diagnosis of germ cell tumor and post-chemotherapy residual retroperitoneal tumor in a cancer referral center over a period of 12 years. The association between the data collected and the post-chemotherapy residual tumor histology was assessed.

Results Sixty-four patients were included with average age of 28.1 years. The mean residual mass size was 6.7 cm. The histology of the mass was teratoma in 60.9%, necrosis 26.5% and viable tumor 12.5%. Prognostic group was associated with the mass histology. Mass with necrosis histology was smaller with mean size of 6.5 cm, while other histologies had an average mass size of 10.4 cm.

Conclusion PC-RPLND is the standard of management of retroperitoneal residual mass after chemotherapy and could over treat in up to 50% of cases. Teratoma component in testicular histology is related to increase size of the residual mass. Histology findings of the retroperitoneal mass are comparable with other series.

Palabras Clave

neoplasias testiculares - disección de ganglios linfáticos retroperitoneales - necrosis - teratoma

Keywords

testicular neoplasms - retroperitoneal lymph node dissection - necrosis - teratoma


Publikationsverlauf

Eingereicht: 31. Mai 2020

Angenommen: 14. September 2020

Artikel online veröffentlicht:
16. Dezember 2020

© 2020. Sociedad Colombiana de Urología. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • Referencias

  • 1 Le Cornet C, Lortet-Tieulent J, Forman D. et al. Testicular cancer incidence to rise by 25% by 2025 in Europe? Model-based predictions in 40 countries using population-based registry data. Eur J Cancer 2014; 50 (04) 831-839
    CrossrefPubMedGoogle Scholar
  • 2 Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018; 68 (06) 394-424
    CrossrefPubMedGoogle Scholar
  • 3 Albers P, Albrecht W, Algaba F. et al; European Association of Urology. Guidelines on Testicular Cancer: 2015 Update. Eur Urol 2015; 68 (06) 1054-1068
    CrossrefPubMedGoogle Scholar
  • 4 Motzer RJ, Jonasch E, Agarwal N. et al. Testicular Cancer, Version 2.2015. J Natl Compr Canc Netw 2015; 13 (06) 772-799
    CrossrefPubMedGoogle Scholar
  • 5 Heidenreich A, Pfister D, Witthuhn R, Thüer D, Albers P. Postchemotherapy retroperitoneal lymph node dissection in advanced testicular cancer: radical or modified template resection. Eur Urol 2009; 55 (01) 217-224
    CrossrefPubMedGoogle Scholar
  • 6 Steyerberg EW, Keizer HJ, Fosså SD. et al. Prediction of residual retroperitoneal mass histology after chemotherapy for metastatic nonseminomatous germ cell tumor: multivariate analysis of individual patient data from six study groups. J Clin Oncol 1995; 13 (05) 1177-1187
    CrossrefPubMedGoogle Scholar
  • 7 International Germ Cell Cancer Collaborative Group. International Germ Cell Consensus Classification: a prognostic factor-based staging system for metastatic germ cell cancers. J Clin Oncol 1997; 15 (02) 594-603
    CrossrefPubMedGoogle Scholar
  • 8 Winter C, Pfister D, Busch J. et al. Residual tumor size and IGCCCG risk classification predict additional vascular procedures in patients with germ cell tumors and residual tumor resection: a multicenter analysis of the German Testicular Cancer Study Group. Eur Urol 2012; 61 (02) 403-409
    CrossrefPubMedGoogle Scholar
  • 9 Russell CM, Sharma P, Agarwal G. et al. Is percent seminoma associated with intraoperative morbidity during post-chemotherapy RPLND?. Can J Urol 2016; 23 (01) 8127-8134
    PubMedGoogle Scholar
  • 10 Cary C, Masterson TA, Bihrle R, Foster RS. Contemporary trends in postchemotherapy retroperitoneal lymph node dissection: Additional procedures and perioperative complications. Urol Oncol 2015; 33 (09) 389.e15-389.e21
    CrossrefPubMedGoogle Scholar
  • 11 Albers P, Weissbach L, Krege S. et al; German Testicular Cancer Study Group. Prediction of necrosis after chemotherapy of advanced germ cell tumors: results of a prospective multicenter trial of the German Testicular Cancer Study Group. J Urol 2004; 171 (05) 1835-1838
    CrossrefPubMedGoogle Scholar
  • 12 Steyerberg EW, Keizer HJ, Sleijfer DT. et al. Retroperitoneal metastases in testicular cancer: role of CT measurements of residual masses in decision making for resection after chemotherapy. Radiology 2000; 215 (02) 437-444
    CrossrefPubMedGoogle Scholar
  • 13 Heidenreich A, Thüer D, Polyakov S. Postchemotherapy retroperitoneal lymph node dissection in advanced germ cell tumours of the testis. Eur Urol 2008; 53 (02) 260-272
    CrossrefPubMedGoogle Scholar
  • 14 Aprikian AG, Herr HW, Bajorin DF, Bosl GJ. Resection of postchemotherapy residual masses and limited retroperitoneal lymphadenectomy in patients with metastatic testicular nonseminomatous germ cell tumors. Cancer 1994; 74 (04) 1329-1334
    CrossrefPubMedGoogle Scholar
  • 15 Djaladat H, Nichols C, Daneshmand S. Adjuvant surgery in testicular cancer patients undergoing postchemotherapy retroperitoneal lymph node dissection. Ann Surg Oncol 2012; 19 (07) 2388-2393
    CrossrefPubMedGoogle Scholar
  • 16 Oldenburg J, Alfsen GC, Lien HH, Aass N, Waehre H, Fossa SD. Postchemotherapy retroperitoneal surgery remains necessary in patients with nonseminomatous testicular cancer and minimal residual tumor masses. J Clin Oncol 2003; 21 (17) 3310-3317
    CrossrefPubMedGoogle Scholar
  • 17 Ozen H, Ekici S, Sozen S, Ergen A, Tekgül S, Kendi S. Resection of residual masses alone: an alternative in surgical therapy of metastatic testicular germ cell tumors after chemotherapy. Urology 2001; 57 (02) 323-327
    CrossrefPubMedGoogle Scholar
  • 18 Vergouwe Y, Steyerberg EW, Foster RS, Habbema JD, Donohue JP. Validation of a prediction model and its predictors for the histology of residual masses in nonseminomatous testicular cancer. J Urol 2001; 165 (01) 84-88 , discussion 88
    CrossrefPubMedGoogle Scholar
  • 19 Leão R, Nayan M, Punjani N. et al. A New Model to Predict Benign Histology in Residual Retroperitoneal Masses After Chemotherapy in Nonseminoma. Eur Urol Focus 2018; 4 (06) 995-1001
    CrossrefPubMedGoogle Scholar
  • 20 Carver BS, Bianco Jr FJ, Shayegan B. et al. Predicting teratoma in the retroperitoneum in men undergoing post-chemotherapy retroperitoneal lymph node dissection. J Urol 2006; 176 (01) 100-103 , discussion 103–104
    CrossrefPubMedGoogle Scholar