SURGICAL APPROACH TO PATIENTS WITH PROGRESSED-STAGE TESTICULAR CANCER : CLINICAL STUDY OF ONE-STAGE OPERATION FOR RESIDUAL MASSES IN RETROPERITONEAL, THORACIC AND CERVICAL AREAS

Abstract

Primary chemotherapy and postchemotherapeutic salvage surgery for residual tumors were definite strategies for progressive testicular cancer. To resect multiple metastatic lesions, the one-stage operation consisted of retroperitoneal lymphnode dissection, thoracotomy, sternotomy or cervical dissection was performed by the staffs of urological and surgical units. Although the operation took a rather long time, no definite complications did not occur.The metastatic lesions were able to be resected completely in all cases.Recurrence occured in 2 patients with pure teratoma and another salvage surgery was performed to them. As a current status, three patients have no evidence of disease and one have no radiographical abnormality with a slight elevation of β-hCG level. We concluded that the one-stage operation for multiple lesions was well tolerable and was beneficial for the management of progressive testicular cancer.