• Clinics · Jan 2024

    Prolonged survival after thoracic metastasectomy in patients with nonseminomatous testicular cancer.

    • Jaqueline Schaparini Fonini, de AraujoPedro Henrique Xavier NabucoPHXNThoracic Surgical Oncology, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil; Thoracic Surgical Oncology, Hospital das Clínicas, Faculdade de Medicina, Univer, Paula Duarte D'Ambrosio, SalernoJuliana Vieira de OliveiraJVOThoracic Surgery Department, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil., Pedro Prosperi Desenzi Ciaralo, Ricardo Mingarini Terra, and Paulo Manuel Pêgo-Fernandes.
    • Thoracic Surgery Department, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil. Electronic address: j.fonini@hc.fm.usp.br.
    • Clinics (Sao Paulo). 2024 Jan 1; 79: 100338100338.

    IntroductionAlmost 20 % of patients with Non-Seminomatous Germinative Cell Tumors (NSGCT) will require intrathoracic metastasectomy after chemotherapy. The authors aim to determine their long-term survival rates.MethodsRetrospective study including patients with NSGCT and intrathoracic metastasis after systemic therapy from January 2011 to June 2022. Treatment outcomes and overall survival were analyzed with the Kaplan-Meier method.ResultsThirty-seven male patients were included with a median age of 31.8 years. Six presented with synchronous mediastinum and lung metastasis, nine had only lung, and 22 had mediastinal metastasis. Over half had retroperitoneal lymph node metastasis. Twenty-two had dissimilar pathologies, with a discordance rate of 62 %. Teratoma and embryonal carcinoma were the prevalent primary tumor types, 40.5 % each, while teratoma was predominant (70.3 %) in the metastasis group. Thoracotomy was the main surgical approach (39.2 %) followed by VATS (37.2 %), cervico-sternotomy (9.8 %), sternotomy (5.8 %), and clamshell (3.9 %). Lung resection was performed in 40.5 % of cases. Overall, 10-year survival rates were 94.3 % with no surgical-related mortality.ConclusionMultimodality treatment with systemic therapy followed by radical surgery offers a high cure rate to patients with intrathoracic metastatic testicular germ cell tumors.Copyright © 2024 HCFMUSP. Published by Elsevier España, S.L.U. All rights reserved.

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