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Surgical resection of solitary metastases after chemotherapy in patients with nonseminomatous germ cell tumors and elevated serum tumor markers
Author(s) -
Wood David P.,
Herr Hary W.,
Motzer Robert J.,
Reuter Victor,
Sogani Pramod C.,
Morse Michael J.,
Bosl George J.
Publication year - 1992
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19921101)70:9<2354::aid-cncr2820700924>3.0.co;2-u
Subject(s) - medicine , chemotherapy , germ cell tumors , germ cell , resection , oncology , surgical resection , surgery , biochemistry , chemistry , gene
Background . Chemorefractory metastatic germ cell tumors and elevated tumor markers generally indicate inoperable disease. Methods . Solitary metastases were resected in 15 patients who had a nonseminomatous germ cell tumor and an elevated alpha‐fetoprotein (AFP) and/or human chorionic gonadotropin (HCG) serum level after treatment with cisplatin‐based chemotherapy. Patients underwent resection for a residual mass after chemotherapy or for a new solitary metastasis after achieving a complete response (CR) to salvage chemotherapy. Results . Seven patients were disease‐free after surgical resection alone. All five patients with an elevated HCG level had a relapse after surgery compared with 3 of 10 patients with only an elevated AFP level. Only 4 of 10 patients with a retroperitoneal metastasis had a relapse after surgery compared with 4 of 5 patients with visceral disease. Eleven of 15 patients overall were disease‐free after surgery and subsequent chemotherapy after a relapse. Conclusions . Surgical resection of a solitary metastasis despite elevated serum tumor markers should be considered in patients who have not had a durable CR to cisplatin‐based chemotherapy. Cancer 1992; 702354‐2357.