ArticleWorld journal of urology2025
Thoracic residual germ cell tumor resection after high-dose chemotherapy with autologous stem cell transplantation in relapsed patients.
Article in World journal of urology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeThe pathological and patient outcomes after the resection of residual thoracic germ cell tumors following sequential high-dose chemotherapy with autologous stem cell transplantation (HDC + SC) have rarely been investigated.
methodsWe retrospectively analyzed 79 male patients who underwent resection for residual germ cell tumors after HDC + SC between 1999 and 2017. Patient information, tumor characteristics, and short-term outcomes were analyzed. Long-term outcomes and survival curves were analyzed via the Kaplan‒Meier-method.
resultsIn the HDC + SC cohort, lung metastases were observed in 88.6% of patients, mediastinal metastases in 24.1%, retrocrural metastases in 8.9%, and cervical metastases in 7.6%. Among those with pulmonary involvement, 67.1% presented with bilateral disease. Additional metastatic sites treated in the HDC + SC setting included the retroperitoneum (32.9%), liver (8.9%), brain (21.5%), and bone (5.1%). Postoperative histology following thoracic resections revealed necrosis in 49.4% of cases, teratoma in 26.6%, and viable malignancy in 24%. In patients undergoing multiple thoracic resections, discordant histological findings between different sites were identified in 24.53%. The rates of minor and major morbidity were 6.3% and 10.1%, respectively, with no 90-day mortality observed. Median follow-up was 123 months, and the 5-year overall survival reached 76%.
conclusionsAfter sequential high-dose chemotherapy with autologous stem cell transplantation and partly high tumor burden, thoracic residual tumor resection can be performed with low morbidity and good long-term survival. Only about half of the histologies following high-dose chemotherapy are complete necroses, and the high rate of discordant histologies emphasize the importance of complete and bilateral resection.
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