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Hepatic resection for disseminated germ cell carcinoma
R J Goulet1, J M Hardacre, L H Einhorn
1Department of Surgery, Indiana University Medical Center, Indianapolis 46223.
Annals of Surgery
|September 1, 1990
Summary
Resecting residual liver disease after chemotherapy for testicular cancer is safe and improves survival. Histology of the resected specimen predicts patient outcomes in this aggressive cancer treatment.
Area of Science:
- Oncology
- Surgical Oncology
- Chemotherapy
Background:
- Improvements in surgical techniques and perioperative care have broadened the use of hepatic resection for metastatic cancers.
- Aggressive surgical removal of residual disease in the lungs and retroperitoneum is standard for disseminated germ cell carcinoma, but hepatic disease resection has not been well-studied.
Purpose of the Study:
- To evaluate the safety and efficacy of hepatic resection for residual liver disease in patients with disseminated testicular carcinoma after chemotherapy.
Main Methods:
- A prospective randomized study of 28 patients with testicular cancer who underwent resection of residual hepatic disease after achieving serologic remission.
- Most resections were performed concurrently with other cytoreductive procedures.
- Patients were stratified by the most aggressive histology in the resected specimen.
Main Results:
- No operative deaths occurred, but 28% of patients experienced complications.
- The 2-year survival rate was 54% with a mean follow-up of 34 months.
- Histologic classification of the resected specimen predicted survival.
Conclusions:
- Hepatic resection is a safe and viable component of treatment for disseminated testicular carcinoma.
- Histologic assessment of resected liver tissue is crucial for predicting patient survival.