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Updated: Jul 10, 2026
An Orthotopic Endometrial Cancer Model with Retroperitoneal Lymphadenopathy Made From In Vivo Propagated and Cultured VX2 Cells
Published on: September 12, 2019
Viable germ cell tumor at postchemotherapy retroperitoneal lymph node dissection: can we predict patients at risk of
Philippe E Spiess1, Nizar M Tannir, Shi-Ming Tu
1Department of Urologic Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.
Background:
Patients with viable tumor at time of postchemotherapy retroperitoneal lymph node dissection (PC-RPLND) are at an increased risk of disease progression. The objective of the current study was to determine the clinical variables that predict this adverse outcome.
Methods:
Between 1980 and 2003, 236 patients with testicular cancer underwent PC-RPLND, 41 of whom (17%) were found to have viable tumor. The authors retrospectively reviewed the patients' medical records for pertinent clinical and treatment-related outcomes. At a median follow-up of 3.9 years, 18 patients (44%) had developed disease recurrence and 12 patients (29%) had died of disease.
Results:
The group of patients who developed postoperative disease recurrence had a larger median dimension of the retroperitoneal mass (7.0 cm and 3.5 cm, respectively; P = .03). The use of adjuvant chemotherapy after PC-RPLND was less common in those patients developing postoperative disease recurrence (P = .06). On multivariate analysis, patients classified as being at intermediate or poor risk according to the International Germ Cell Consensus Classification (IGCCC) had a poorer recurrence-free survival (P = .006 and P = .07, respectively). On multivariate analysis, predictors of disease-specific survival (DSS) included an elevated alpha-fetoprotein (AFP) level before PC-RPLND (P = .003) and postoperative disease recurrence (P = .02). A serum AFP level >5.3 ng/mL before PC-RPLND was found to be predictive of a poorer DSS (P = .0007).
Conclusions:
Patients with viable tumor at the time of PC-RPLND are at an increased risk of disease progression. Clinical variables including classification as intermediate or poor IGCCC risk, a preoperative serum AFP level >5.3 ng/mL, and postoperative disease recurrence help to better define those patients who are at risk of future adverse outcomes.
