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Management of Residual Mass in Germ Cell Tumors After Chemotherapy

  • Genitourinary Cancers (DP Petrylak and JW Kim, Section Editors)
  • Published:
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Abstract

Purpose of Review

The purpose of this review is to educate medical oncologists on the management of patients with residual germ cell tumors and the role of surgical resection after platinum-based chemotherapy.

Recent Findings

Patients with non-seminomatous testicular cancer and residual enlarged retroperitoneal lymph nodes > 1 cm following induction chemotherapy with normal tumor markers should undergo a post-chemotherapy retroperitoneal lymph node dissection. All patients with primary mediastinal non-seminoma should undergo surgical resection of the mediastinal mass post-chemotherapy. These are complex surgeries and require expert surgeons in high-volume centers. Patients with advanced testicular seminoma who have residual masses less than 3 cm after chemotherapy can be observed without further intervention. Patients with a residual mass > 3 cm should be evaluated with PET scan after 6 weeks of chemotherapy. Residual mass with negative PET scan can be followed by surveillance while a positive PET scan requires further work up to rule out active disease.

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Author information

Authors and Affiliations

  1. Department of Medicine, Indiana University School of Medicine, 535 Barnhill Dr. RT 473, Indianapolis, IN, 46202, USA

    Costantine Albany

  2. Department of Surgery, Indiana University School of Medicine, 545 Barnhill Dr EH 212, Indianapolis, IN, 46202, USA

    Kenneth Kesler

  3. Department of Urology, Indiana University School of Medicine, 535 Barnhill Dr., Indianapolis, IN, 46202, USA

    Clint Cary

Authors
  1. Costantine Albany
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  2. Kenneth Kesler
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  3. Clint Cary
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Correspondence to Costantine Albany.

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Albany, C., Kesler, K. & Cary, C. Management of Residual Mass in Germ Cell Tumors After Chemotherapy. Curr Oncol Rep 21, 5 (2019). https://doi.org/10.1007/s11912-019-0758-6

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