Surgical resection of solitary metastases after chemotherapy in patients with nonseminomatous germ cell tumors and elevated serum tumor markers
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 (H...
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| Veröffentlicht in: | Cancer 1992-11, Vol.70 (9), p.2354-2357 |
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| container_title | Cancer |
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| creator | Wood, David P. Herr, Hary W. Motzer, Robert J. Reuter, Victor Sogani, Pramod C. Morse, Michael J. Bosl, George J. |
| description | 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. |
| doi_str_mv | 10.1002/1097-0142(19921101)70:9<2354::AID-CNCR2820700924>3.0.CO;2-U |
| format | Article |
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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.</description><identifier>ISSN: 0008-543X</identifier><identifier>EISSN: 1097-0142</identifier><identifier>DOI: 10.1002/1097-0142(19921101)70:9<2354::AID-CNCR2820700924>3.0.CO;2-U</identifier><identifier>PMID: 1382832</identifier><identifier>CODEN: CANCAR</identifier><language>eng</language><publisher>New York: Wiley Subscription Services, Inc., A Wiley Company</publisher><subject>alpha-Fetoproteins - analysis ; Antineoplastic agents ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Biological and medical sciences ; Biomarkers, Tumor - blood ; Chemotherapy, Adjuvant ; Chorionic Gonadotropin - blood ; Cisplatin - administration & dosage ; Combined treatments (chemotherapy of immunotherapy associated with an other treatment) ; elevated tumor markers ; germ cell tumors ; Humans ; Ifosfamide - administration & dosage ; Lymphatic Metastasis ; Medical sciences ; metastatic ; Neoplasm Recurrence, Local ; Neoplasms, Germ Cell and Embryonal - blood ; Neoplasms, Germ Cell and Embryonal - drug therapy ; Neoplasms, Germ Cell and Embryonal - secondary ; Neoplasms, Germ Cell and Embryonal - surgery ; Pharmacology. Drug treatments ; Prognosis ; Remission Induction ; Retroperitoneal Neoplasms - drug therapy ; Retroperitoneal Neoplasms - secondary ; Retroperitoneal Neoplasms - surgery ; Salvage Therapy ; surgical resection ; Survival Rate</subject><ispartof>Cancer, 1992-11, Vol.70 (9), p.2354-2357</ispartof><rights>Copyright © 1992 American Cancer Society</rights><rights>1993 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c4984-550150c063c8d4c5026782a5258acc2ef089f8bc2390bb002ca8e5ea8f6bb1533</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=4361082$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/1382832$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wood, David P.</creatorcontrib><creatorcontrib>Herr, Hary W.</creatorcontrib><creatorcontrib>Motzer, Robert J.</creatorcontrib><creatorcontrib>Reuter, Victor</creatorcontrib><creatorcontrib>Sogani, Pramod C.</creatorcontrib><creatorcontrib>Morse, Michael J.</creatorcontrib><creatorcontrib>Bosl, George J.</creatorcontrib><title>Surgical resection of solitary metastases after chemotherapy in patients with nonseminomatous germ cell tumors and elevated serum tumor markers</title><title>Cancer</title><addtitle>Cancer</addtitle><description>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.</description><subject>alpha-Fetoproteins - analysis</subject><subject>Antineoplastic agents</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Biomarkers, Tumor - blood</subject><subject>Chemotherapy, Adjuvant</subject><subject>Chorionic Gonadotropin - blood</subject><subject>Cisplatin - administration & dosage</subject><subject>Combined treatments (chemotherapy of immunotherapy associated with an other treatment)</subject><subject>elevated tumor markers</subject><subject>germ cell tumors</subject><subject>Humans</subject><subject>Ifosfamide - administration & dosage</subject><subject>Lymphatic Metastasis</subject><subject>Medical sciences</subject><subject>metastatic</subject><subject>Neoplasm Recurrence, Local</subject><subject>Neoplasms, Germ Cell and Embryonal - blood</subject><subject>Neoplasms, Germ Cell and Embryonal - drug therapy</subject><subject>Neoplasms, Germ Cell and Embryonal - secondary</subject><subject>Neoplasms, Germ Cell and Embryonal - surgery</subject><subject>Pharmacology. Drug treatments</subject><subject>Prognosis</subject><subject>Remission Induction</subject><subject>Retroperitoneal Neoplasms - drug therapy</subject><subject>Retroperitoneal Neoplasms - secondary</subject><subject>Retroperitoneal Neoplasms - surgery</subject><subject>Salvage Therapy</subject><subject>surgical resection</subject><subject>Survival Rate</subject><issn>0008-543X</issn><issn>1097-0142</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1992</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqVkV2LEzEYhYMoa139CUIuRPRi6ptk0sl0RVjGr4XFgloQvAiZ9J1tdD5qknHpr_Avm6F1RS8EIRDCOTkczkNIxWDOAPgzBmWRAcv5E1aWnDFgTwtYls-5kPlyeX7xMqveVe-54lAAlDx_IeYwr1ZnPFvfIrOb37fJDABUJnPx6S65F8KX9Cy4FCfkhAnFleAz8uPD6K-cNS31GNBGN_R0aGgYWheN39MOownpYKCmieip3WI3xC16s9tT19OdiQ77GOi1i1vaD33AzvVDZ-IwBnqFvqMW25bGsRt8Cuk3FFv8biJuaEA_dgeFdsZ_RR_ukzuNaQM-ON6nZP361cfqbXa5enNRnV9mNi9VnkkJTIKFhbBqk1sJfFEobiSXyljLsQFVNqq2XJRQ12lUaxRKNKpZ1DWTQpySx4fcnR--jRii7lyYipoeU3FdCM5ZXqhk_HwwWj-E4LHRO-9S2b1moCdcehpcT4PrX7h0AbrUEy6tEy79Jy4tNOhqpblep_SHxxpj3eHmd_aBT9IfHXUTEqTGm966cGPLxYKBmmzNwXbtWtz_X8N_FvxLET8BUczC8A</recordid><startdate>19921101</startdate><enddate>19921101</enddate><creator>Wood, David P.</creator><creator>Herr, Hary W.</creator><creator>Motzer, Robert J.</creator><creator>Reuter, Victor</creator><creator>Sogani, Pramod C.</creator><creator>Morse, Michael J.</creator><creator>Bosl, George J.</creator><general>Wiley Subscription Services, Inc., A Wiley Company</general><general>Wiley-Liss</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19921101</creationdate><title>Surgical resection of solitary metastases after chemotherapy in patients with nonseminomatous germ cell tumors and elevated serum tumor markers</title><author>Wood, David P. ; Herr, Hary W. ; Motzer, Robert J. ; Reuter, Victor ; Sogani, Pramod C. ; Morse, Michael J. ; Bosl, George J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4984-550150c063c8d4c5026782a5258acc2ef089f8bc2390bb002ca8e5ea8f6bb1533</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1992</creationdate><topic>alpha-Fetoproteins - analysis</topic><topic>Antineoplastic agents</topic><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Biomarkers, Tumor - blood</topic><topic>Chemotherapy, Adjuvant</topic><topic>Chorionic Gonadotropin - blood</topic><topic>Cisplatin - administration & dosage</topic><topic>Combined treatments (chemotherapy of immunotherapy associated with an other treatment)</topic><topic>elevated tumor markers</topic><topic>germ cell tumors</topic><topic>Humans</topic><topic>Ifosfamide - administration & dosage</topic><topic>Lymphatic Metastasis</topic><topic>Medical sciences</topic><topic>metastatic</topic><topic>Neoplasm Recurrence, Local</topic><topic>Neoplasms, Germ Cell and Embryonal - blood</topic><topic>Neoplasms, Germ Cell and Embryonal - drug therapy</topic><topic>Neoplasms, Germ Cell and Embryonal - secondary</topic><topic>Neoplasms, Germ Cell and Embryonal - surgery</topic><topic>Pharmacology. Drug treatments</topic><topic>Prognosis</topic><topic>Remission Induction</topic><topic>Retroperitoneal Neoplasms - drug therapy</topic><topic>Retroperitoneal Neoplasms - secondary</topic><topic>Retroperitoneal Neoplasms - surgery</topic><topic>Salvage Therapy</topic><topic>surgical resection</topic><topic>Survival Rate</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wood, David P.</creatorcontrib><creatorcontrib>Herr, Hary W.</creatorcontrib><creatorcontrib>Motzer, Robert J.</creatorcontrib><creatorcontrib>Reuter, Victor</creatorcontrib><creatorcontrib>Sogani, Pramod C.</creatorcontrib><creatorcontrib>Morse, Michael J.</creatorcontrib><creatorcontrib>Bosl, George J.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wood, David P.</au><au>Herr, Hary W.</au><au>Motzer, Robert J.</au><au>Reuter, Victor</au><au>Sogani, Pramod C.</au><au>Morse, Michael J.</au><au>Bosl, George J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Surgical resection of solitary metastases after chemotherapy in patients with nonseminomatous germ cell tumors and elevated serum tumor markers</atitle><jtitle>Cancer</jtitle><addtitle>Cancer</addtitle><date>1992-11-01</date><risdate>1992</risdate><volume>70</volume><issue>9</issue><spage>2354</spage><epage>2357</epage><pages>2354-2357</pages><issn>0008-543X</issn><eissn>1097-0142</eissn><coden>CANCAR</coden><abstract>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.</abstract><cop>New York</cop><pub>Wiley Subscription Services, Inc., A Wiley Company</pub><pmid>1382832</pmid><doi>10.1002/1097-0142(19921101)70:9<2354::AID-CNCR2820700924>3.0.CO;2-U</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | alpha-Fetoproteins - analysis Antineoplastic agents Antineoplastic Combined Chemotherapy Protocols - therapeutic use Biological and medical sciences Biomarkers, Tumor - blood Chemotherapy, Adjuvant Chorionic Gonadotropin - blood Cisplatin - administration & dosage Combined treatments (chemotherapy of immunotherapy associated with an other treatment) elevated tumor markers germ cell tumors Humans Ifosfamide - administration & dosage Lymphatic Metastasis Medical sciences metastatic Neoplasm Recurrence, Local Neoplasms, Germ Cell and Embryonal - blood Neoplasms, Germ Cell and Embryonal - drug therapy Neoplasms, Germ Cell and Embryonal - secondary Neoplasms, Germ Cell and Embryonal - surgery Pharmacology. Drug treatments Prognosis Remission Induction Retroperitoneal Neoplasms - drug therapy Retroperitoneal Neoplasms - secondary Retroperitoneal Neoplasms - surgery Salvage Therapy surgical resection Survival Rate |
| title | Surgical resection of solitary metastases after chemotherapy in patients with nonseminomatous germ cell tumors and elevated serum tumor markers |
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