
Surgical controversies in the management of post-chemotherapy nonretroperitoneal residual disease in metastatic nonseminomatous germ cell tumors
Author(s) -
Durgatosh Pandey,
Pankaj Garg,
M. D. Ray,
Ashutosh Mishra
Publication year - 2016
Publication title -
south asian journal of cancer
Language(s) - English
Resource type - Journals
eISSN - 2278-4306
pISSN - 2278-330X
DOI - 10.4103/2278-330x.179702
Subject(s) - medicine , chemotherapy , disease , germ cell tumors , surgery , oncology
Following the advent of platinum-based chemotherapy, Surgery, excepting orchidectomy, has become an adjunct treatment in the management of metastatic non-seminomatous germ cell tumors (NSGCT). Role of surgery comes into play in metastatic NSGCT when residual disease persists following standard chemotherapy. Surgical excision of all post chemotherapy residual disease at all places, whenever surgically feasible with acceptable morbidity and mortality, should be undertaken. As histopathological examination of the excised postchemotherapy residue shows only necrosis and fibrosis in significant number of patients; surgical exercise in this group of patients seems futile and unwarranted retrospectively. This issue becomes more contentious when surgeons are confronted with multiple nonretroperitoneal post chemotherapy residues. This article aims to deal with the management of postchemotherapy nonretroperitoneal residues in metastatic NSGCT.