OBJECTIVE: To determine the pathologic findings and clinical outcome of patients with pure embryonal carcinoma (EC) of the testis who were diagnosed with testis cancer from January 1989 to January 2013 who underwent an orchiectomy, cisplatin-based chemotherapy and a postchemotherapy retroperitoneal lymph node dissection (PC-RPLND). METHODS: We compared those patients with 100% EC with those with mixed nonseminomatous germ cell tumor pathology who underwent a PC-RPLND. RESULTS: Of 1105 patients who underwent a PC-RPLND, 145 had pure EC. Twenty-six percent of patients presented with metastatic disease outside the retroperitoneum. Patients with mixed histologies tended to have worse International Germ Cell Cancer Collaborative Group risk compared to those with EC at orchiectomy (P = .037). Histology at PC-RPLND revealed fibrosis or necrosis in 76%, mature teratoma in 19% and viable cancer in 4%. Over one-third of the patients had a residual mass of <1 cm prior to RPLND; of whom 15% harbored mature teratoma in PC-RPLND histology. The Kaplan-Meier estimated probability of recurrence at 5 years of follow-up was 3.1% (95% CI 1.2%, 8.0%) for EC histology, 7.3% lower than mixed histology. For cancer-specific mortality, the Kaplan-Meier estimated probability at 5 years was 4.6% (95% CI 3.3%, 6.3%) and 1.7% (95% CI 0.4%, 6.8%) for mixed and pure EC histologies, respectively. CONCLUSION: Approximately 20% of patients with pure EC had teratoma at PC-RPLND. We have shown that those with a maximum node size of <1 cm should not be precluded from RPLND.
OBJECTIVE: To determine the pathologic findings and clinical outcome of patients with pure embryonal carcinoma (EC) of the testis who were diagnosed with testis cancer from January 1989 to January 2013 who underwent an orchiectomy, cisplatin-based chemotherapy and a postchemotherapy retroperitoneal lymph node dissection (PC-RPLND). METHODS: We compared those patients with 100% EC with those with mixed nonseminomatous germ cell tumor pathology who underwent a PC-RPLND. RESULTS: Of 1105 patients who underwent a PC-RPLND, 145 had pure EC. Twenty-six percent of patients presented with metastatic disease outside the retroperitoneum. Patients with mixed histologies tended to have worse International Germ Cell Cancer Collaborative Group risk compared to those with EC at orchiectomy (P = .037). Histology at PC-RPLND revealed fibrosis or necrosis in 76%, mature teratoma in 19% and viable cancer in 4%. Over one-third of the patients had a residual mass of <1 cm prior to RPLND; of whom 15% harbored mature teratoma in PC-RPLND histology. The Kaplan-Meier estimated probability of recurrence at 5 years of follow-up was 3.1% (95% CI 1.2%, 8.0%) for EC histology, 7.3% lower than mixed histology. For cancer-specific mortality, the Kaplan-Meier estimated probability at 5 years was 4.6% (95% CI 3.3%, 6.3%) and 1.7% (95% CI 0.4%, 6.8%) for mixed and pure EC histologies, respectively. CONCLUSION: Approximately 20% of patients with pure EC had teratoma at PC-RPLND. We have shown that those with a maximum node size of <1 cm should not be precluded from RPLND.
Authors: Brett S Carver; Fernando J Bianco; Bobby Shayegan; Andrew Vickers; Robert J Motzer; George J Bosl; Joel Sheinfeld Journal: J Urol Date: 2006-07 Impact factor: 7.450
Authors: G Varuni Kondagunta; Jennifer Bacik; Dean Bajorin; Deborah Dobrzynski; Joel Sheinfeld; Robert J Motzer; George J Bosl Journal: J Clin Oncol Date: 2005-12-20 Impact factor: 44.544
Authors: R J Motzer; A Amsterdam; V Prieto; J Sheinfeld; V V Murty; M Mazumdar; G J Bosl; R S Chaganti; V E Reuter Journal: J Urol Date: 1998-01 Impact factor: 7.450
Authors: H J Schmoll; R Souchon; S Krege; P Albers; J Beyer; C Kollmannsberger; S D Fossa; N E Skakkebaek; R de Wit; K Fizazi; J P Droz; G Pizzocaro; G Daugaard; P H M de Mulder; A Horwich; T Oliver; R Huddart; G Rosti; L Paz Ares; O Pont; J T Hartmann; N Aass; F Algaba; M Bamberg; I Bodrogi; C Bokemeyer; J Classen; S Clemm; S Culine; M de Wit; H G Derigs; K P Dieckmann; M Flasshove; X Garcia del Muro; A Gerl; J R Germa-Lluch; M Hartmann; A Heidenreich; W Hoeltl; J Joffe; W Jones; G Kaiser; O Klepp; S Kliesch; L Kisbenedek; K U Koehrmann; M Kuczyk; M P Laguna; O Leiva; V Loy; M D Mason; G M Mead; R P Mueller; N Nicolai; G O N Oosterhof; T Pottek; O Rick; H Schmidberger; F Sedlmayer; W Siegert; U Studer; S Tjulandin; H von der Maase; P Walz; S Weinknecht; L Weissbach; E Winter; C Wittekind Journal: Ann Oncol Date: 2004-09 Impact factor: 32.976
Authors: Susanne Krege; Jörg Beyer; Rainer Souchon; Peter Albers; Walter Albrecht; Ferran Algaba; Michael Bamberg; István Bodrogi; Carsten Bokemeyer; Eva Cavallin-Ståhl; Johannes Classen; Christoph Clemm; Gabriella Cohn-Cedermark; Stéphane Culine; Gedske Daugaard; Pieter H M De Mulder; Maria De Santis; Maike de Wit; Ronald de Wit; Hans Günter Derigs; Klaus-Peter Dieckmann; Annette Dieing; Jean-Pierre Droz; Martin Fenner; Karim Fizazi; Aude Flechon; Sophie D Fosså; Xavier Garcia del Muro; Thomas Gauler; Lajos Geczi; Arthur Gerl; Jose Ramon Germa-Lluch; Silke Gillessen; Jörg T Hartmann; Michael Hartmann; Axel Heidenreich; Wolfgang Hoeltl; Alan Horwich; Robert Huddart; Michael Jewett; Johnathan Joffe; William G Jones; László Kisbenedek; Olbjørn Klepp; Sabine Kliesch; Kai Uwe Koehrmann; Christian Kollmannsberger; Markus Kuczyk; Pilar Laguna; Oscar Leiva Galvis; Volker Loy; Malcolm D Mason; Graham M Mead; Rolf Mueller; Craig Nichols; Nicola Nicolai; Tim Oliver; Dalibor Ondrus; Gosse O N Oosterhof; Luis Paz Ares; Giorgio Pizzocaro; Jörg Pont; Tobias Pottek; Tom Powles; Oliver Rick; Giovanni Rosti; Roberto Salvioni; Jutta Scheiderbauer; Hans-Ulrich Schmelz; Heinz Schmidberger; Hans-Joachim Schmoll; Mark Schrader; Felix Sedlmayer; Niels E Skakkebaek; Aslam Sohaib; Sergei Tjulandin; Padraig Warde; Stefan Weinknecht; Lothar Weissbach; Christian Wittekind; Eva Winter; Lori Wood; Hans von der Maase Journal: Eur Urol Date: 2007-12-26 Impact factor: 20.096