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Therapeutic Advances in Urology
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Reviews

Management of the residual post-chemotherapy retroperitoneal mass in germ cell tumors

Hugh J. Lavery

Department of Urology, Ohio State University Medical Center, 456 West 10th Ave, Columbus, Ohio, OH 43210, USA, hugh.lavery{at}mountsinai.org

Robert R. Bahnson

Department of Urology, Ohio State University Medical Center, 456 West 10th Ave, Columbus, Ohio, OH 43210, USA

David S. Sharp

Department of Urology, Ohio State University Medical Center, 456 West 10th Ave, Columbus, Ohio, OH 43210, USA

Kamal S. Pohar

Department of Urology, Ohio State University Medical Center, 456 West 10th Ave, Columbus, Ohio, OH 43210, USA

The management of the residual mass in the retroperitoneum following induction chemotherapy for metastatic testicular cancer has evolved over the past three decades. A multidisciplinary approach involving cisplatin-based chemotherapy and postchemotherapy retroperitoneal lymph node dissection (PC-RPLND) has increased long-term survival rates above 80%. Advances into the appropriate patient selection and timing of surgery have lowered morbidity while improving oncologic outcomes. However, areas of controversy still exist within the field. Management of the small residual mass, predictors of the histology of the residual mass, the extent of PC-RPLND, the role of PC-RPLND in the setting of elevated serum tumor markers, and the role of positron-emission tomography are all topics of ongoing research and debate. We will discuss these issues and review the current guidelines for the management of the residual postchemotherapy retroperitoneal mass in this review.

Key Words: testes • neoplasm • residual • seminoma • neoplasm • germ cell • retroperitoneal lymph node dissection • post-chemotherapy

Therapeutic Advances in Urology, Vol. 1, No. 4, 199-207 (2009)
DOI: 10.1177/1756287209350315
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