938 POST-CHEMOTHERAPY RESPONSE ASSESSED WITH COMPUTED TOMOGRAPHIC VOLUMETRIC ANALYSIS OF LYMPH-NODE METASTASIS IN NON-SEMINOMATOUS GERM CELL TUMORS

Abstract

You have accessJournal of UrologyPenis/Testis/Urethra: Benign & Malignant Disease (III)1 Apr 2013938 POST-CHEMOTHERAPY RESPONSE ASSESSED WITH COMPUTED TOMOGRAPHIC VOLUMETRIC ANALYSIS OF LYMPH-NODE METASTASIS IN NON-SEMINOMATOUS GERM CELL TUMORS Carlos Basilio-de Leo, Carolina Culebro-García, Christian Villeda-Sandoval, Francisco Rodríguez-Covarrubias, Mariano Sotomayor-de Zavaleta, Guillermo Feria-Bernal, and Ricardo Castillejos-Molina Carlos Basilio-de LeoCarlos Basilio-de Leo México, D.F, Mexico More articles by this author , Carolina Culebro-GarcíaCarolina Culebro-García México, D.F, Mexico More articles by this author , Christian Villeda-SandovalChristian Villeda-Sandoval México, D.F, Mexico More articles by this author , Francisco Rodríguez-CovarrubiasFrancisco Rodríguez-Covarrubias México, D.F, Mexico More articles by this author , Mariano Sotomayor-de ZavaletaMariano Sotomayor-de Zavaleta México, D.F, Mexico More articles by this author , Guillermo Feria-BernalGuillermo Feria-Bernal México, D.F, Mexico More articles by this author , and Ricardo Castillejos-MolinaRicardo Castillejos-Molina México, D.F, Mexico More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.517AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Computed Tomography (CT) scan is the standard method for evaluation of retroperitoneal lymph node invasion for non-seminomatous germ cell tumors (NSGCT). RECIST criteria and volumetric analysis are used for some solid tumors, but never been evaluated for testicular tumor and lymph node metastasis. The purpose of this study is to evaluate volumetric assessment and RECIST criteria as new methodologies for follow-up in patients treated with chemotherapy for NSGCTs metastatic to retroperitoneal lymph nodes. METHODS Retrospective single center analysis of a testicular tumor database. Patients with the diagnosis of NSGCTs and retroperitoneal lymph node metastases were selected. We included patients who received chemotherapy (BEP) and had serial CT scans before and after treatment. Lymph nodes detected were measured in a venous contrast-phase. Volumetric analysis and RECIST criteria were used to calculate response rates, we proposed and used new cut-off values classification and also those proposed by RECIST. A correlation between volumetric and RECIST criteria with histological and clinical variables was calculated. RESULTS Seventeen patients met the inclusion criteria. The histologic distribution of primary tumor components was: 70% embryonic carcinoma, 47% teratoma and 47% seminoma. The mean baseline volume of retroperitoneal metastases was 439cc (range 5.3-5965 cc), and the mean volume post-chemotherapy was 30cc (range 0-193 cc). The response rate for all retroperitoneal metastases was 68% (range −57.3% to 100%). According to RECIST criteria the mean baseline diameter was 4.83cc (range 1.5-18.5 cc), and the mean diameter post-chemotherapy was 2.6cc (range 0-6.01 cc). The response rate by RECIST for all retroperitoneal metastasis was 43.02% (range −20% to 100%). Post-chemotherapy residual mass correlated in both classifications with teratoma (volumetric p=0.019, RECIST p=0.006); the response rate was associated with the need of a second treatment (lymphadenectomy [p= 0.027]). We propose a volumetric classification for chemotherapy response: this classification correlates with the need of further treatment (p=0.049), RECIST criteria did not have such correlation. CONCLUSIONS There are no previous studies evaluating and classifying the response rate of lymph node metastases after chemotherapy in NSGCT. RECIST criteria and volumetric analysis are adequate methods for assessing response. Our classification showed a correlation with the need of salvage therapy after failure to chemotherapy. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e386 Peer Review Report Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Carlos Basilio-de Leo México, D.F, Mexico More articles by this author Carolina Culebro-García México, D.F, Mexico More articles by this author Christian Villeda-Sandoval México, D.F, Mexico More articles by this author Francisco Rodríguez-Covarrubias México, D.F, Mexico More articles by this author Mariano Sotomayor-de Zavaleta México, D.F, Mexico More articles by this author Guillermo Feria-Bernal México, D.F, Mexico More articles by this author Ricardo Castillejos-Molina México, D.F, Mexico More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...