Hepatic metastasectomy for testicular germ cell tumors: Is it worth it?

Y. Nancy You, Bradley C. Leibovitch, Florencia G. Que

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

Background: Chemotherapy is highly effective for metastatic germ cell tumor (GCT), but experience with resection of hepatic metastases from GCT is limited. Methods: Fifteen patients with GCT metastatic to the liver underwent 16 hepatic operations (1975-2002). Pre-resection therapy, surgical pathology, and operative outcomes were reviewed. All patients were followed to death or last contact for survival and disease status. Results: Patients underwent biopsy (three), wedge resection (nine), bisegmentectomy (two), and major lobectomy (two). Hepatic histology included: necrosis (33%), viable tumor (27%), mature teratoma (13%), and benign histology (27%). Concomitant resection of extrahepatic disease (14 patients, 93%) found necrosis (53%), mature teratoma (27%), and viable tumor (13%). Operative mortality was 0% and morbidity was 40%. At 8.2 years (mean) from resection, 11 patients (73%) were alive: five with no evidence of disease, two with elevated tumor marker only, and four with gross disease. Four patients (27%) died. The 10-year overall survival was 62% from diagnosis. Conclusion: Resection of post-chemotherapy hepatic disease is safe, even when combined with resection of extrahepatic residual disease. The varied histologic findings, lack of reliable predictors, and prolonged survival achieved support a multidisciplinary approach which includes surgical resection of hepatic metastases.

Original languageEnglish (US)
Pages (from-to)595-601
Number of pages7
JournalJournal of Gastrointestinal Surgery
Volume13
Issue number4
DOIs
StatePublished - Apr 2009

Keywords

  • Germ cell tumor
  • Hepatic metastases
  • Liver resection
  • Testicular cancer

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

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