Skip to main content
SpringerLink
Log in

Results of salvage retroperitoneal lymphadenectomy (RLA) in the treatment of patients with nonseminomatous germ cell tumours remaining marker positive after inductive chemotherapy

  • Published:
International Urology and Nephrology Aims and scope Submit manuscript

Abstract

The authors describe the evidence and results obtained in 21 out of 100 patients who underwent salvage retroperitoneal lymphadenectomy for advanced testicular cancer (UICC stage II/B bulky and stage III) in the period 1982–1993, and in whom inductive chemotherapy was not followed by marker conversion. It is stated that if AFP positivity is low (titres below 100 ng/ml) salvage retroperitoneal lymphadenectomy (RLA) is of high therapeutic value, whereas in all cases with HCG positivity or AFP titres higher than 500 ng/ml tumorous death ensued without exception. In our cases viable tumour residues occurred in 81%. Salvage resection was feasible in 76%, but every incomplete resection (19%) was followed by death due to tumour. In all but one of the cases marker positivity, an indicator of therapy-resistant viable tumour residues, persisted after having used more than four PVB combinations or changes in the chemotherapeutic regimen.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Ami Sidi, A., Rei-Kwen Chion, Lange, Ph.: Recent reflections on tumor markers.World J. Urol., 21, 18 (1984).

    Article  Google Scholar 

  2. Behrendt, H., Ringert, R. H., Pfeiffer, R., Homann, W., Hartung, R.: Grenzen der tumormarkerorientierten Verlaufskontrolle beim chemotherapierten, metastasierenden, nichtseminomatösen Hodentumor.Urol. Int., 117, 291 (1977).

    Google Scholar 

  3. Bodrogi, I.: Results, place and role of modern chemotherapy in male germ cell tumours (in Hungarian). Candidate's Thesis, Budapest 1990.

  4. Bussar-Maatz, R., Weissbach, L., Dahlmann, N., Mann, K.: Der “falschpositive” Tumormarker beim malignen Hodentumor.Urologe [A],32, 177 (1993).

    PubMed  CAS  Google Scholar 

  5. Eastham, J. A., Wilson, T. G., Russell, C. H., Ahlering, T. E., Skinner, D. G.: Surgical resection in patients with nonseminomatous germ cell tumor who fail to normalize serum tumor markers after chemotherapy.Urology, 42, 74 (1994).

    Article  Google Scholar 

  6. Edmonds, P. M., Oliver, R. T.: Testis cancer.Curr. Opin. Urol., 3, 409 (1993).

    Article  Google Scholar 

  7. Flanigen, R. C., Trockman, B. A.: Miscellaneous aspects of bladder and testicular oncology.Curr. Opin. Urol., 3, 418 (1993).

    Article  Google Scholar 

  8. Geldermann, W. A., Schraffordt Koops, H., Sleijfer, D. T.: The extent of surgery after chemotherapy for advanced germ cell tumors.J. Urol., 133, 10 (1989).

    Google Scholar 

  9. Goepel, M., Otto, T., Seeber, S., Rübben, H.: Prospektive Studie zur verzögerten retroperitonealen Lymphadenektomie (RLA) bei Patienten mit nichtseminomatösem Germinalzelltumor (NSGT) und fehlender Markerkonversion.Urologe [A], Suppl.2, S 36 (1993).

    Google Scholar 

  10. Hendry, W. F., Áttern, P., Hetherington, J. W., Peckham, M. J., Dearnley D. P., Horwich, A.: Para-aortic lymphadenectomy after chemotherapy for metastatic nonseminomatous germ cell tumours: Prognostic value, and therapeutic benefit.Br. J. Urol., 71, 208 (1993).

    Article  PubMed  CAS  Google Scholar 

  11. Klein, E. A.: Tumor markers in testis cancer.Urol. Clin. N. Amer., 20, 67 (1993).

    CAS  Google Scholar 

  12. Motzer, R. J., Corpe, K., Geller, N. L., Bajorin, D. E., Dimitrovsky, E., Herr, H., Morse, M., Fair, W., Sogani, P., Russo, P.: The role of ifosfamide plus cisplatin-based chemotherapy as salvage therapy for patients with refractory germ-cell tumors.Cancer, 60, 2467 (1990).

    Google Scholar 

  13. Murphy, B. R., Breeden, E. S., Donohue, J. P., Messemer, J., Walsh, W., Roth, B. J., Einhorn, L. H.: Surgical salvage of chemorefractory germ cell tumors.J. Clin. Oncol., 11, 324 (1993).

    PubMed  CAS  Google Scholar 

  14. Nijman, J. M., Schraffordt Koops, H., Oldhoff, J.: Sexual function after surgery and combination chemotherapy in men with disseminated nonseminomatous testicular cancer.J. Clin. Oncol., 38, 182 (1988).

    CAS  Google Scholar 

  15. van der Gaast, A., Hoekstra, J. W., Croles, J. J., Splinter, T. A. W.: Elevated serum tumor markers in patients with testicular cancer after induction chemotherapy due to a reservoir of markers in cystic differentiated mature teratoma.J. Urol., 145, 829 (1991).

    PubMed  Google Scholar 

  16. Wood, D. P., Herr, H. W., Motzer, R. J., Reuter, V., Sogani, P. C., Morse, M. J., Bosl, G. J.: Surgical resection of solitary metastases after chemotherapy in patients with non-seminomatous germ cell tumors and elevated serum tumor markers.Cancer, 70, 2354 (1992).

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Urology, Jahn Ferenc South-Pest Hospital, Budapest

    L. Kisbenedek, P. Szeldeli & P. Tenke

  2. Department of Chemotherapy, National Institute of Oncology, Budapest

    I. Bodrogi, M. Baki & J. Horti

Authors
  1. L. Kisbenedek
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. I. Bodrogi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. P. Szeldeli
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. Baki
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. P. Tenke
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. J. Horti
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kisbenedek, L., Bodrogi, I., Szeldeli, P. et al. Results of salvage retroperitoneal lymphadenectomy (RLA) in the treatment of patients with nonseminomatous germ cell tumours remaining marker positive after inductive chemotherapy. International Urology and Nephrology 27, 325–329 (1995). https://doi.org/10.1007/BF02564770

Download citation

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02564770

Keywords

Search

Navigation