Management of the post-chemotherapy residual mass in patients with advanced stage non-seminomatous germ cell tumors (nsgct)

Postchemotherapy Retroperitoneal Surgery Remains Necessary in Patients With Nonseminomatous Testicular Cancer and Minimal Residual Tumor Masses

“…26,27 Two decades ago, this always meant bilateral lymph node dissection, including the retrocrural and ipsilateral iliac region. 26,27 Two decades ago, this always meant bilateral lymph node dissection, including the retrocrural and ipsilateral iliac region.…”

Canadian consensus guidelines for the management of testicular germ cell cancer

“…In addition, relapse rates after primary chemotherapy are low with 4% to 9% for clinical stage IIA and 11% to 15% for clinical stage IIB disease. 86,87 Patients with elevated serum tumour AFP, HCG or LDH and/or CS IIB are therefore treated with primary chemotherapy according to the algorithms for patients with advanced disease, according to International Germ Cell Cancer Collaborative Group (IGCCCG) recommendations. 10,69,88 Patients without marker elevations but with retroperitoneal lymph nodes 1 to 2 cm, suspected to be CS IIA, represent a particular problem.…”

Giant residual non-seminonatous mediastinal mass

“…In contrast, during several investigation, the application of the above mentioned criteria resulted in a false negative prediction of approximately 20%. And in some studies no factors has been identified for residual lung or mediastinal mass that could be used to select a group of patients who could safely avoid surgery 1,2,4,5 . If serum markers have normalized after chemotherapy, resection of all residual abnormalities on imaging studies of the mediastinum is recommended 2,3 .…”