Predictive factors for additional vascular procedures in patients with germ cell tumors (GCT) and residual tumor resection (RTR): A multicenter analysis of the German Testicular Cancer Study Groups (GTCSG).

Abstract

e15050 Background: The aim of this analysis was to identify parameters to predict additional vascular procedures during RTR in a multicenter setting in patients (pts) with GCT after chemotherapy. Methods: A retrospective analysis was performed in 411 GCT pts who underwent RTR in multiple centers. 380 of 411 pts had a sufficient follow-up and were evaluable with complete data sets. The RTR database was queried for additional vascular procedures (cava resection, aortic prosthesis) and correlated to IGCCCG classification and residual tumor volume. The median age of patients was 32 yrs (14-67). 44% of patients initially had IGCCCG intermediate/poor prognosis features. Results: In 34 RTRs a vena cava resection was necessary. The necessity of vena cava resection was significantly correlated with initial IGCCCG classification (16.6% intermediate/poor vs. 4.5% good; p<0.001) but not with tumor size (9.2% residual tumor size <5cm vs. 17.2% residual tumor size >5cm; p=0.0624). In 5 patients an aortic resection and prosthesis during RTR was required. There was no significant correlation to IGCCCG (2.2% intermediate/poor vs. 0.7% good; p=0.2877) but to tumor size (0.6% residual tumor size <5cm vs. 4.5% residual tumor size >5cm; p=0.0340). Conclusions: The necessity for additional vascular procedures (cava resection, aortic prosthesis) during RTR is correlated to the residual tumor size and initial IGCCCG classification. Patients with high volume residual tumors (>5cm) and with IGCCCG intermediate/poor risk features can be initially identified as high risk patients for vascular procedures and therefore should be referred to specialized surgical centers with ad hoc possibility of vascular interventions.