Clinical outcome after retroperitoneal lymphadenectomy of patients with pure testicular teratoma.

Abstract

OBJECTIVES:

To determine the pathologic findings and clinical outcome of patients with pure teratoma of the testis who underwent primary or postchemotherapy retroperitoneal lymphadenectomy (RPLND).

METHODS:

From January 1989 to February 1998, 29 patients with pure testicular teratoma underwent primary (n = 11) or postchemotherapy (n = 18) RPLND.

RESULTS:

Overall, 23 (79%) of 29 patients had retroperitoneal disease, with 18 (62%) initially presenting with advanced disease. The pathologic stage in the 11 patients undergoing primary RPLND was pN0 in 6 (55%), pN1 in 3 (27%), and pN2 in 2 (18%). Of the 7 patients with clinical Stage I undergoing primary RPLND, 1 had teratoma and 1 had seminoma in the retroperitoneum; of the 4 patients with clinical Stage IIA, 2 had teratoma and 1 had embryonal carcinoma. Four patients were lost to follow-up and the other seven had no evidence of disease (NED) at a median follow-up of 90.4 months, with no relapses. The pathologic findings in the 18 patients undergoing postchemotherapy RPLND revealed fibrosis in 8, teratoma in 9, and yolk sac tumor in 1. At last follow-up, 7 of the 9 patients with teratoma were NED, 1 was dead of disease, and 1 was dead of unknown causes. Of the 8 patients with fibrosis, 6 had NED and 2 were lost to follow-up. The patient with viable cancer had NED at last follow-up.

CONCLUSIONS:

These data underscore the metastatic potential of pure testicular teratoma. A significant proportion (45%) of patients with low-stage pure testicular teratoma had retroperitoneal disease. Furthermore, a high proportion (62%) presented initially with advanced disease and demonstrated a considerable risk of relapse despite complete resection or favorable histologic features in the resected retroperitoneal specimen.

• Authors: Farhang Rabbani, Hesam Farivar-Mohseni, Antonio Leon, Robert J Motzer, George J Bosl, Joel Sheinfeld
• Journal: Urology (Urology) Vol. 62 Issue 6 Pg. 1092-6 (Dec 2003) ISSN: 1527-9995 [Electronic] United States
• PMID: 14665362 (Publication Type: Journal Article, Review)

Topics

• Adolescent
• Adult
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Carcinoma, Embryonal (secondary, surgery)
• Cohort Studies
• Combined Modality Therapy
• Follow-Up Studies
• Humans
• Lymph Node Excision (statistics & numerical data)
• Lymphatic Metastasis
• Male
• Neoplasm Staging
• Prospective Studies
• Retroperitoneal Fibrosis (surgery)
• Retroperitoneal Space
• Seminoma (secondary, surgery)
• Teratoma (drug therapy, secondary, surgery)
• Testicular Neoplasms (drug therapy, pathology, surgery)
• Treatment Outcome