PD5-07 INTRATUBULAR GERM CELL NEOPLASIA AND MULTIFOCALITY IN TESTICULAR GERM CELL TUMORS

Abstract

chemotherapy and five had salvage chemotherapy. Eighteen had teratoma in the RC nodes, 1 had viable tumor, 2 had teratoma and viable tumor and 4 had fibrosis. The concordance with the retroperitoneal pathology was 84%. During PC-RPLND 6 patients had nephrectomy, 3 required a chest tube, 2 patients underwent resection of an intracaval thrombus, and one patient had revascularization of the superior mesenteric artery. The 5-year CSS after RC dissection during PC-RPLND was 69% (95%CI: 39%-86%). The initial CS in the redo RPLND group was advanced disease in 10 patients and CS IIa in 2. Seven were IGCCCG good risk, 1 intermediate risk, 2 poor risk and two had insufficient data. Five patients were treated with chemotherapy at time of relapse and 7 were treated with upfront surgery. Of 12 patients, 10 had teratoma found in the RC nodes, one had teratoma with malignant transformation and one had viable tumor. The concordance with the retroperitoneum was 100%. The 5-year CSS after RC dissection during redo RPLND was 63% (95%CI: 24%-87%). CONCLUSIONS: RC involvement is encountered in patients with bulky retroperitoneal disease. Due to the high rate of disease found in patients with preoperative imaging suggestive of RC involvement, and the high concordance with the disease found in the retroperitoneum, a complete resection of all residual RC disease should be performed. Appropriate preparation for adjunctive procedures is essential prior to surgery.