ANAHEIM, CA (UroToday.com) - In the study, Recurrence in Patients with PNO at RPLND: Can We Predict Which Patients are at Risk, the authors reviewed their treatment-related outcomes in patients with no evidence of viable germ cell tumor elements at the time of post-chemotherapy retroperitoneal lymph node dissection (PC-RPLND) performed for metastatic non-seminomatous germ cell testis tumors. From 1980 to 2003, 195 patients underwent PC-RPLND with the absence of viable cancer at the time of surgery, with fibrosis only in 97 patients and teratoma in 98 patients. First-line chemotherapy (prior to surgery) was administered to 165 patients and salvage chemotherapy to 30 patients.

The overall 5-year disease-specific (DSS) and recurrence-free (RFS) survival rates were 88% and 79%, respectively. On Cox multivariate regression analysis, advanced clinical stage (IIC-III) and poor International Germ Cell Consensus Classification (IGCCC) Risk Category was associated with poorer RFS whereas an elevated serum beta-HCG prior to PC-RPLND and an increasing size of the retroperitoneal mass on pathology was associated with poorer DSS. A specific cutpoint for the serum beta-HCG greater than 1.2 mIU/ml and a size of the retroperitoneal mass greater than 2.5 cm was associated with worst DSS. In a subset analysis of patients with fibrosis only within the PC-RPLND specimen, date of surgery between 1980 to 1990 and poor IGCCC risk category was associated with poorer RFS and an elevated serum beta-HCG prior to PC-RPLND remained associated with poorer DSS.

( ABST [998] - Penis/Testis/Urethra: Benign and Malignant Disease (III))

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Written by Ashish M. Kamat, a Contributing Editor with UroToday.

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