Journal
UROLOGY
Volume 102, Issue -, Pages 159-162Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.urology.2016.08.063
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OBJECTIVE To evaluate the clinicopathologic features and predictors of pelvic metastasis in patients with germ cell tumors. METHODS Between 1990 and 2009, 2722 patients undergoing retroperitoneal lymph node dissection ( RPLND) were prospectively included in our institution's testis cancer database. Patients with pelvic disease were identified and clinicopathologic features were analyzed. RESULTS Of the 134 patients, 14.5% had a history of prior groin surgery. At the time of referral, 98% had received prior chemotherapy, 19.4% had undergone prior RPLND, and 24% presented as late relapse. Surgery consisted of pelvic excision alone in 37 ( 27.6%) and pelvic excision with primary RPLND in 2 ( 1.5%) or with postchemotherapy RPLND in 95 ( 70.9%). Median pelvic mass size was 6.5 cm. Pathology of pelvic disease revealed teratoma in 74 ( 55%), nonseminomatous germ cell tumor in 28 ( 21%), sarcoma in 8 ( 6%), and necrosis in 22 ( 16.5%). Patients with pelvic metastases had a statistically higher initial stage of presentation ( P <.001) and had a higher incidence of prior groin surgeries ( P <.001). CONCLUSION Pelvic metastasis in testicular cancer is uncommon and can be a site of late relapse. These patients tend to present with high-volume retroperitoneal disease or a history of prior groin surgeries. Surgery is curative in most patients, and pelvic pathology was teratoma in more than half. (C) 2016 Elsevier Inc.
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