Back to Search
Start Over
Hepatic metastasectomy for testicular germ cell tumors: is it worth it?
- Source :
-
Journal of Gastrointestinal Surgery . Apr2009, Vol. 13 Issue 4, p595-601. 7p. 2 Charts, 2 Graphs. - Publication Year :
- 2009
-
Abstract
- <bold>Background: </bold>Chemotherapy is highly effective for metastatic germ cell tumor (GCT), but experience with resection of hepatic metastases from GCT is limited.<bold>Methods: </bold>Fifteen patients with GCT metastatic to the liver underwent 16 hepatic operations (1975-2002). Pre-resection therapy, surgical pathology, and operative outcomes were reviewed. All patients were followed to death or last contact for survival and disease status.<bold>Results: </bold>Patients underwent biopsy (three), wedge resection (nine), bisegmentectomy (two), and major lobectomy (two). Hepatic histology included: necrosis (33%), viable tumor (27%), mature teratoma (13%), and benign histology (27%). Concomitant resection of extrahepatic disease (14 patients, 93%) found necrosis (53%), mature teratoma (27%), and viable tumor (13%). Operative mortality was 0% and morbidity was 40%. At 8.2 years (mean) from resection, 11 patients (73%) were alive: five with no evidence of disease, two with elevated tumor marker only, and four with gross disease. Four patients (27%) died. The 10-year overall survival was 62% from diagnosis.<bold>Conclusion: </bold>Resection of post-chemotherapy hepatic disease is safe, even when combined with resection of extrahepatic residual disease. The varied histologic findings, lack of reliable predictors, and prolonged survival achieved support a multidisciplinary approach which includes surgical resection of hepatic metastases. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 1091255X
- Volume :
- 13
- Issue :
- 4
- Database :
- Academic Search Index
- Journal :
- Journal of Gastrointestinal Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 44065484
- Full Text :
- https://doi.org/10.1007/s11605-009-0807-9