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Surgical Management of Cervical Non-seminomatous Germ Cell Tumor Metastases
- Source :
- The LaryngoscopeBIBLIOGRAPHY. 131(7)
- Publication Year :
- 2020
-
Abstract
- OBJECTIVE/HYPOTHESIS Testicular cancer is the most common malignancy of young males. Limited reports describe perioperative and long-term outcomes after surgical resection of metastatic, cervical, non-seminomatous germ cell tumors (NSGCT). The objective of this study was to investigate the effectiveness and safety of cervical lymphadenectomy in the management of metastatic NSGCT. STUDY DESIGN Retrospective case series. METHODS A single institution, retrospective review from 1998 to 2020 of patients with metastatic NSGCT who underwent cervical lymphadenectomy was conducted. Clinicopathological, surgical, and postoperative data were collected and analyzed. RESULTS Sixty-eight predominantly white (91.0%) male patients with mean age 33.0 ± 11.3 years were included. Most (82.2%) presented with stage III disease at initial diagnosis. All patients had undergone primary platinum-based chemotherapy 1.0 to 22.7 months prior to selective ND. Surgery mainly involved nodal levels III (67.6%), IV (92.6%) and/or Vb (77.9%) and was frequently performed with concomitant thoracoabdominal NSGCT resections (63.2%). Cervical specimens predominantly revealed mature teratoma (83.8%) as solitary (69.1%) or component of mixed (14.7%) NSGCT. Ten (14.7%) perioperative complications occurred as vocal cord paresis (n = 6) from thoracic surgery and chyle leakage (n = 4). All resolved conservatively except two vocal cord paralyzes that required surgical repair due to tumor involvement of vagus nerve. Six instances of cervical recurrence occurred at median 12.5 (range, 5.8-38.6) months from ND, all re-demonstrating purely mature teratoma. The two-year cervical, non-cervical, and overall recurrence-free survivals were 83%, 55%, and 55%, respectively. Two-year disease-free and overall survivals were both 93%. CONCLUSIONS Selective neck dissection is a safe, effective method for managing cervical NSGCT metastases. LEVEL OF EVIDENCE 4 Laryngoscope, 131:1528-1534, 2021.
- Subjects :
- Adult
Male
medicine.medical_specialty
medicine.medical_treatment
Malignancy
Disease-Free Survival
03 medical and health sciences
Young Adult
0302 clinical medicine
Testicular Neoplasms
Antineoplastic Combined Chemotherapy Protocols
Testis
medicine
Humans
030223 otorhinolaryngology
Testicular cancer
Neoplasm Staging
Retrospective Studies
business.industry
Head and neck cancer
Teratoma
Neck dissection
Perioperative
Neoplasms, Germ Cell and Embryonal
medicine.disease
Neoadjuvant Therapy
Surgery
Otorhinolaryngology
Cardiothoracic surgery
Chemotherapy, Adjuvant
030220 oncology & carcinogenesis
Concomitant
Lymphatic Metastasis
Lymph Node Excision
Neck Dissection
Germ cell tumors
Lymph Nodes
Neoplasm Recurrence, Local
business
Orchiectomy
Subjects
Details
- ISSN :
- 15314995
- Volume :
- 131
- Issue :
- 7
- Database :
- OpenAIRE
- Journal :
- The LaryngoscopeBIBLIOGRAPHY
- Accession number :
- edsair.doi.dedup.....77ad0f054cc24b23384bee42f9cbd697