MP37-20 SURGICAL MANAGEMENT OF THE GROWING TERATOMA SYNDROME: A MULTICENTER STUDY

Abstract

You have accessJournal of UrologySexual Function/Dysfunction: Penis/Testis/Urethra: Benign Disease & Malignant Disease I1 Apr 2018MP37-20 SURGICAL MANAGEMENT OF THE GROWING TERATOMA SYNDROME: A MULTICENTER STUDY Pia Paffenholz, David Pfister, and Axel Heidenreich Pia PaffenholzPia Paffenholz More articles by this author , David PfisterDavid Pfister More articles by this author , and Axel HeidenreichAxel Heidenreich More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1226AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The growing teratoma syndrome (GTS) is an infrequent clinical phenomenon constituting only about 2 to 8% of all testis cancer patients. Data in the literature on the therapy of GTS are sparse, reflecting the rarity of the disease. The purpose of this study was to evaluate the diagnostic, surgical and oncological outcome of patients with GTS treated in the 21st century. METHODS We performed a retrospective analysis including 680 patients with advanced non-seminomatous germ cell tumors that underwent a post-chemotherapeutic retroperitoneal lymph node dissection. We analysed the peri- and postoperative outcome of 22 patients (3%) that fulfilled the criteria of a GTS: enlarging metastatic mass in the retroperitoneum or visceral organs during systemic chemotherapy with normalized or decreasing tumor markers. RESULTS Mean patient age was 28 years (22-34). 17 (81%) and 3 (14%) patients were classified as good or intermediate prognosis according to the IGCCCG risk classification, while 1 patient (5%) was in the poor prognosis group. The median tumour diameter at time of surgery was 6 cm (4-12.2). In order to completely resect the residual masses, adjunctive surgery had to be performed in 4 (18%) of all patients: resection of the abdominal aorta, inferior vena cava or renal vain with a graft replacement, nephrectomy and resection of parts of the intestine. 8 postoperative minor or major complications occurred, with 4 complications affecting only 1 patient. After a median follow-up of 25 month (8-47), 2 (9%) patients developed an in-field or out-field recurrence, respectively; all but one patients are alive showing an overall survival of 95.5%. CONCLUSIONS GTS is a rare disease among patients with advanced non-seminomatous germ cell tumors and necessitates complete surgical resection of the masses with curative intention. Due to its complexity, surgery should be performed in tertiary referral centers only. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e499 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Pia Paffenholz More articles by this author David Pfister More articles by this author Axel Heidenreich More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...