Clinical parameters that predict histology of postchemotherapy retroperitoneal lymph node mass in testicular cancer

Mizuki Onozawa, Koji Kawai, Takahiro Yamamoto, Shiro Hinotsu, Sadamu Tsukamoto, Kazunori Hattori, Naoto Miyanaga, Toru Shimazui, Hideyuki Akaza

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Since the advent of cisplatin-based chemotherapy, the majority of metastatic testicular cancers can be cured by chemotherapy followed by retroperitoneal lymph node dissection (RPLND). However, postchemotherapy RPLND confers no therapeutic benefit if the residual mass contains no viable cells. Therefore, to determine which parameters predict a patient's likelihood of having only necrosis in the residual mass, we retrospectively analyzed clinical parameters of patients who underwent postchemotherapy RPLND. Methods: Data from 27 patients with metastatic testicular cancer were analyzed. The histology of the primary tumor was seminoma in 11 cases and non-seminoma in 16 cases. All of the patients with non-seminoma showed a normalization of tumor markers after chemotherapy. Analysis of clinical parameters included data for the initial histology, pretreatment tumor marker levels, postchemotherapy retroperitoneal mass size, and the histology of the dissected RPLNs. Results: Histological examination of dissected RPLNs showed residual tumor in 27% of seminoma patients and 38% of non-seminoma patients. In seminoma patients, no viable cells were found in all six patients with pretreatment lactate dehydrogenase (LDH) levels below 7.5 times the upper limit of normal, or in all five of the patients with postchemotherapy RPLNs less than 2.5 cm. In non-seminoma patients, no viable cells were found in nine of 10 patients with pretreatment alpha-fetoprotein (AFP) levels less than 2700 ng/mL, or in eight of nine patients with residual mass less than 2.5 cm. Conclusions: Both postchemotherapy RPLN mass size and pretreatment tumor marker levels are possible predictors for necrosis of the residual mass in testicular cancer patients.

Original languageEnglish
Pages (from-to)535-541
Number of pages7
JournalInternational Journal of Urology
Volume11
Issue number7
DOIs
Publication statusPublished - Jul 2004
Externally publishedYes

Fingerprint

Testicular Neoplasms
Histology
Lymph Nodes
Seminoma
Tumor Biomarkers
Lymph Node Excision
Drug Therapy
Necrosis
Residual Neoplasm
alpha-Fetoproteins
L-Lactate Dehydrogenase
Cisplatin

Keywords

  • Drug therapy
  • Lymph nodes
  • Metastasis
  • Pathology
  • Testicular neoplasms

ASJC Scopus subject areas

  • Urology

Cite this

Clinical parameters that predict histology of postchemotherapy retroperitoneal lymph node mass in testicular cancer. / Onozawa, Mizuki; Kawai, Koji; Yamamoto, Takahiro; Hinotsu, Shiro; Tsukamoto, Sadamu; Hattori, Kazunori; Miyanaga, Naoto; Shimazui, Toru; Akaza, Hideyuki.

In: International Journal of Urology, Vol. 11, No. 7, 07.2004, p. 535-541.

Research output: Contribution to journalArticle

Onozawa, M, Kawai, K, Yamamoto, T, Hinotsu, S, Tsukamoto, S, Hattori, K, Miyanaga, N, Shimazui, T & Akaza, H 2004, 'Clinical parameters that predict histology of postchemotherapy retroperitoneal lymph node mass in testicular cancer', International Journal of Urology, vol. 11, no. 7, pp. 535-541. https://doi.org/10.1111/j.1442-2042.2004.00832.x
Onozawa, Mizuki ; Kawai, Koji ; Yamamoto, Takahiro ; Hinotsu, Shiro ; Tsukamoto, Sadamu ; Hattori, Kazunori ; Miyanaga, Naoto ; Shimazui, Toru ; Akaza, Hideyuki. / Clinical parameters that predict histology of postchemotherapy retroperitoneal lymph node mass in testicular cancer. In: International Journal of Urology. 2004 ; Vol. 11, No. 7. pp. 535-541.
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abstract = "Background: Since the advent of cisplatin-based chemotherapy, the majority of metastatic testicular cancers can be cured by chemotherapy followed by retroperitoneal lymph node dissection (RPLND). However, postchemotherapy RPLND confers no therapeutic benefit if the residual mass contains no viable cells. Therefore, to determine which parameters predict a patient's likelihood of having only necrosis in the residual mass, we retrospectively analyzed clinical parameters of patients who underwent postchemotherapy RPLND. Methods: Data from 27 patients with metastatic testicular cancer were analyzed. The histology of the primary tumor was seminoma in 11 cases and non-seminoma in 16 cases. All of the patients with non-seminoma showed a normalization of tumor markers after chemotherapy. Analysis of clinical parameters included data for the initial histology, pretreatment tumor marker levels, postchemotherapy retroperitoneal mass size, and the histology of the dissected RPLNs. Results: Histological examination of dissected RPLNs showed residual tumor in 27{\%} of seminoma patients and 38{\%} of non-seminoma patients. In seminoma patients, no viable cells were found in all six patients with pretreatment lactate dehydrogenase (LDH) levels below 7.5 times the upper limit of normal, or in all five of the patients with postchemotherapy RPLNs less than 2.5 cm. In non-seminoma patients, no viable cells were found in nine of 10 patients with pretreatment alpha-fetoprotein (AFP) levels less than 2700 ng/mL, or in eight of nine patients with residual mass less than 2.5 cm. Conclusions: Both postchemotherapy RPLN mass size and pretreatment tumor marker levels are possible predictors for necrosis of the residual mass in testicular cancer patients.",
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AU - Onozawa, Mizuki

AU - Kawai, Koji

AU - Yamamoto, Takahiro

AU - Hinotsu, Shiro

AU - Tsukamoto, Sadamu

AU - Hattori, Kazunori

AU - Miyanaga, Naoto

AU - Shimazui, Toru

AU - Akaza, Hideyuki

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N2 - Background: Since the advent of cisplatin-based chemotherapy, the majority of metastatic testicular cancers can be cured by chemotherapy followed by retroperitoneal lymph node dissection (RPLND). However, postchemotherapy RPLND confers no therapeutic benefit if the residual mass contains no viable cells. Therefore, to determine which parameters predict a patient's likelihood of having only necrosis in the residual mass, we retrospectively analyzed clinical parameters of patients who underwent postchemotherapy RPLND. Methods: Data from 27 patients with metastatic testicular cancer were analyzed. The histology of the primary tumor was seminoma in 11 cases and non-seminoma in 16 cases. All of the patients with non-seminoma showed a normalization of tumor markers after chemotherapy. Analysis of clinical parameters included data for the initial histology, pretreatment tumor marker levels, postchemotherapy retroperitoneal mass size, and the histology of the dissected RPLNs. Results: Histological examination of dissected RPLNs showed residual tumor in 27% of seminoma patients and 38% of non-seminoma patients. In seminoma patients, no viable cells were found in all six patients with pretreatment lactate dehydrogenase (LDH) levels below 7.5 times the upper limit of normal, or in all five of the patients with postchemotherapy RPLNs less than 2.5 cm. In non-seminoma patients, no viable cells were found in nine of 10 patients with pretreatment alpha-fetoprotein (AFP) levels less than 2700 ng/mL, or in eight of nine patients with residual mass less than 2.5 cm. Conclusions: Both postchemotherapy RPLN mass size and pretreatment tumor marker levels are possible predictors for necrosis of the residual mass in testicular cancer patients.

AB - Background: Since the advent of cisplatin-based chemotherapy, the majority of metastatic testicular cancers can be cured by chemotherapy followed by retroperitoneal lymph node dissection (RPLND). However, postchemotherapy RPLND confers no therapeutic benefit if the residual mass contains no viable cells. Therefore, to determine which parameters predict a patient's likelihood of having only necrosis in the residual mass, we retrospectively analyzed clinical parameters of patients who underwent postchemotherapy RPLND. Methods: Data from 27 patients with metastatic testicular cancer were analyzed. The histology of the primary tumor was seminoma in 11 cases and non-seminoma in 16 cases. All of the patients with non-seminoma showed a normalization of tumor markers after chemotherapy. Analysis of clinical parameters included data for the initial histology, pretreatment tumor marker levels, postchemotherapy retroperitoneal mass size, and the histology of the dissected RPLNs. Results: Histological examination of dissected RPLNs showed residual tumor in 27% of seminoma patients and 38% of non-seminoma patients. In seminoma patients, no viable cells were found in all six patients with pretreatment lactate dehydrogenase (LDH) levels below 7.5 times the upper limit of normal, or in all five of the patients with postchemotherapy RPLNs less than 2.5 cm. In non-seminoma patients, no viable cells were found in nine of 10 patients with pretreatment alpha-fetoprotein (AFP) levels less than 2700 ng/mL, or in eight of nine patients with residual mass less than 2.5 cm. Conclusions: Both postchemotherapy RPLN mass size and pretreatment tumor marker levels are possible predictors for necrosis of the residual mass in testicular cancer patients.

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