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Role of postchemotherapy surgery in the management of patients with liver metastases from germ cell tumors

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Role of postchemotherapy surgery in the management of patients with liver metastases from germ cell tumors. / Hartmann, Jörg Thomas; Rick, Oliver; Oechsle, Karin; Kuczyk, Markus; Gauler, Thomas; Schöffski, Patrick; Schleicher, Jan; Mayer, Frank; Teichmann, Reinhard; Kanz, Lothar; Bokemeyer, Carsten.

In: ANN SURG, Vol. 242, No. 2, 08.2005, p. 260-6.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Hartmann, JT, Rick, O, Oechsle, K, Kuczyk, M, Gauler, T, Schöffski, P, Schleicher, J, Mayer, F, Teichmann, R, Kanz, L & Bokemeyer, C 2005, 'Role of postchemotherapy surgery in the management of patients with liver metastases from germ cell tumors', ANN SURG, vol. 242, no. 2, pp. 260-6.

APA

Hartmann, J. T., Rick, O., Oechsle, K., Kuczyk, M., Gauler, T., Schöffski, P., Schleicher, J., Mayer, F., Teichmann, R., Kanz, L., & Bokemeyer, C. (2005). Role of postchemotherapy surgery in the management of patients with liver metastases from germ cell tumors. ANN SURG, 242(2), 260-6.

Vancouver

Hartmann JT, Rick O, Oechsle K, Kuczyk M, Gauler T, Schöffski P et al. Role of postchemotherapy surgery in the management of patients with liver metastases from germ cell tumors. ANN SURG. 2005 Aug;242(2):260-6.

Bibtex

@article{f6189a0b076f4cd2a47050b9ebdb1672,
title = "Role of postchemotherapy surgery in the management of patients with liver metastases from germ cell tumors",
abstract = "OBJECTIVE: To evaluate the role of postchemotherapy adjunctive surgery in patients with liver metastases from germ cell cancer (GCT).PATIENTS AND METHODS: Forty-three male patients with nonseminoma were treated in different multicenter treatment protocols between 1990 and 1999, and they underwent hepatic surgery. The results of postchemotherapy surgical resection, histologic findings found during postchemotherapy surgery, and prognostic factors for survival were assessed.RESULTS: Thirty-five of 43 patients (81%) were initially diagnosed with liver metastases and advanced GCT, and 8 patients (19%) presented with metachronous liver metastases after a median interval of 16 months (range, 6-103 months). Twelve patients (28%) had isolated liver metastases after completion of chemotherapy, while 31 patients (72%) had additional residual extrahepatic tumor masses. Liver surgery included tumor excision or segmentectomy in 32 patients (74%) and hepatectomy (right/left) or resection of multiple segments in 11 patients (26%). Histologic analysis of postchemotherapy resected residua yielded necrosis in 67%, teratoma in 12%, and viable cancer in 21%. Additional resections at other sites have been performed in 31 patients revealing necrosis in 61% (n = 19), teratoma in 29% (n = 9), and vital carcinoma in 10% (n = 3). In 39% of patients, histologic findings differed among liver and other resection sites. Refractoriness to chemotherapy was associated with a shorter survival after surgery, and a trend was seen in patients with elevation of AFP.CONCLUSION: The high rate of viable cancer and teratoma found in liver specimens, differing histologic results at residual tumor locations, and the high survival rate achieved support a multidisciplinary approach including resection of liver masses since no accurate selection of patients can narrow the use of surgery.",
keywords = "Adolescent, Adult, Combined Modality Therapy, Germinoma, Hepatectomy, Humans, Liver Neoplasms, Male, Middle Aged, Neoplasm, Residual, Teratoma, Treatment Outcome",
author = "Hartmann, {J{\"o}rg Thomas} and Oliver Rick and Karin Oechsle and Markus Kuczyk and Thomas Gauler and Patrick Sch{\"o}ffski and Jan Schleicher and Frank Mayer and Reinhard Teichmann and Lothar Kanz and Carsten Bokemeyer",
year = "2005",
month = aug,
language = "English",
volume = "242",
pages = "260--6",
journal = "ANN SURG",
issn = "0003-4932",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

RIS

TY - JOUR

T1 - Role of postchemotherapy surgery in the management of patients with liver metastases from germ cell tumors

AU - Hartmann, Jörg Thomas

AU - Rick, Oliver

AU - Oechsle, Karin

AU - Kuczyk, Markus

AU - Gauler, Thomas

AU - Schöffski, Patrick

AU - Schleicher, Jan

AU - Mayer, Frank

AU - Teichmann, Reinhard

AU - Kanz, Lothar

AU - Bokemeyer, Carsten

PY - 2005/8

Y1 - 2005/8

N2 - OBJECTIVE: To evaluate the role of postchemotherapy adjunctive surgery in patients with liver metastases from germ cell cancer (GCT).PATIENTS AND METHODS: Forty-three male patients with nonseminoma were treated in different multicenter treatment protocols between 1990 and 1999, and they underwent hepatic surgery. The results of postchemotherapy surgical resection, histologic findings found during postchemotherapy surgery, and prognostic factors for survival were assessed.RESULTS: Thirty-five of 43 patients (81%) were initially diagnosed with liver metastases and advanced GCT, and 8 patients (19%) presented with metachronous liver metastases after a median interval of 16 months (range, 6-103 months). Twelve patients (28%) had isolated liver metastases after completion of chemotherapy, while 31 patients (72%) had additional residual extrahepatic tumor masses. Liver surgery included tumor excision or segmentectomy in 32 patients (74%) and hepatectomy (right/left) or resection of multiple segments in 11 patients (26%). Histologic analysis of postchemotherapy resected residua yielded necrosis in 67%, teratoma in 12%, and viable cancer in 21%. Additional resections at other sites have been performed in 31 patients revealing necrosis in 61% (n = 19), teratoma in 29% (n = 9), and vital carcinoma in 10% (n = 3). In 39% of patients, histologic findings differed among liver and other resection sites. Refractoriness to chemotherapy was associated with a shorter survival after surgery, and a trend was seen in patients with elevation of AFP.CONCLUSION: The high rate of viable cancer and teratoma found in liver specimens, differing histologic results at residual tumor locations, and the high survival rate achieved support a multidisciplinary approach including resection of liver masses since no accurate selection of patients can narrow the use of surgery.

AB - OBJECTIVE: To evaluate the role of postchemotherapy adjunctive surgery in patients with liver metastases from germ cell cancer (GCT).PATIENTS AND METHODS: Forty-three male patients with nonseminoma were treated in different multicenter treatment protocols between 1990 and 1999, and they underwent hepatic surgery. The results of postchemotherapy surgical resection, histologic findings found during postchemotherapy surgery, and prognostic factors for survival were assessed.RESULTS: Thirty-five of 43 patients (81%) were initially diagnosed with liver metastases and advanced GCT, and 8 patients (19%) presented with metachronous liver metastases after a median interval of 16 months (range, 6-103 months). Twelve patients (28%) had isolated liver metastases after completion of chemotherapy, while 31 patients (72%) had additional residual extrahepatic tumor masses. Liver surgery included tumor excision or segmentectomy in 32 patients (74%) and hepatectomy (right/left) or resection of multiple segments in 11 patients (26%). Histologic analysis of postchemotherapy resected residua yielded necrosis in 67%, teratoma in 12%, and viable cancer in 21%. Additional resections at other sites have been performed in 31 patients revealing necrosis in 61% (n = 19), teratoma in 29% (n = 9), and vital carcinoma in 10% (n = 3). In 39% of patients, histologic findings differed among liver and other resection sites. Refractoriness to chemotherapy was associated with a shorter survival after surgery, and a trend was seen in patients with elevation of AFP.CONCLUSION: The high rate of viable cancer and teratoma found in liver specimens, differing histologic results at residual tumor locations, and the high survival rate achieved support a multidisciplinary approach including resection of liver masses since no accurate selection of patients can narrow the use of surgery.

KW - Adolescent

KW - Adult

KW - Combined Modality Therapy

KW - Germinoma

KW - Hepatectomy

KW - Humans

KW - Liver Neoplasms

KW - Male

KW - Middle Aged

KW - Neoplasm, Residual

KW - Teratoma

KW - Treatment Outcome

M3 - SCORING: Journal article

C2 - 16041217

VL - 242

SP - 260

EP - 266

JO - ANN SURG

JF - ANN SURG

SN - 0003-4932

IS - 2

ER -