Management of post-chemotherapy extra-retroperitoneal residual masses

Testicular cancer is the most common cancer in men age 20-35 years and accounts for approximately 1% of all male malignancies. While the retroperitoneum is often the first and only site of metastatic disease, approximately 40% of patients presenting with metastatic disease will have disease involving extra-retroperitoneal sites.

A medline review was conducted to evaluate peer-reviewed articles reporting on the outcome of patients with germ cell tumors and extra-retroperitoneal metastases.

Following chemotherapy, approximately 70% of patients will have residual masses in the retroperitoneum and several series demonstrate that approximately 50% of patients will harbor teratoma or viable GCT in the retroperitoneum. Additionally, up to 35% of patients will have radiographic evidence of extra-retroperitoneal (ERP) masses after chemotherapy.

In this manuscript, we will review the current role of surgery for patients with post-chemotherapy residual ERP metastases.