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Testicular Germ Cell Tumors with Venous Tumor Thrombus: Prevalence, Presentation, and Management.
Chahine, Sophia Y; Alkhatib, Khalid Y; Arakelyan, Gevorg; Buxton, Claire; Giannarini, Gianluca; Hamilton, Robert J; Holt, Sarah K; Bernhard, Jean-Christophe; Jiang, Di Maria; Lin, Daniel; Liu, Jen-Jane; Manley, Brandon; Master, Viraj A; Matveev, Vsevolod; Necchi, Andrea; Packiam, Vignesh T; Patel, Sunil H; Peak, Taylor; Peyton, Charles C; Pierorazio, Phillip M; Prakash, Gagan; Salari, Keyan; Sexton, Wade J; Singla, Nirmish; Spiess, Philippe E; Psutka, Sarah P.
Afiliación
  • Chahine SY; University of Washington School of Medicine, Seattle, WA, USA. Electronic address: sophic2@uw.edu.
  • Alkhatib KY; Department of Urology, University of Pennsylvania, Philadelphia, PA, USA.
  • Arakelyan G; N.N. Blokhin Russian Cancer Center, Moscow, Russia.
  • Buxton C; University of Washington School of Medicine, Seattle, WA, USA.
  • Giannarini G; Santa Maria della Misericordia University Hospital, Udine, Italy.
  • Hamilton RJ; Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada.
  • Holt SK; Department of Urology, University of Washington, Seattle, WA, USA.
  • Bernhard JC; Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France.
  • Jiang DM; Princess Margaret Cancer Centre, Toronto, Canada.
  • Lin D; Department of Urology, University of Washington, Seattle, WA, USA; Fred Hutchinson Cancer Center, Seattle, WA, USA.
  • Liu JJ; Oregon Health & Science University, Portland, OR, USA.
  • Manley B; Moffitt Cancer Center, Tampa, FL, USA.
  • Master VA; Emory School of Medicine, Atlanta, GA, USA; Winship Cancer Institute, Atlanta, GA, USA.
  • Matveev V; N.N. Blokhin Russian Cancer Center, Moscow, Russia.
  • Necchi A; Vita-Salute San Raffaele University, Milan, Italy; IRCCS San Raffaele Hospital, Milan, Italy.
  • Packiam VT; Department of Urology, University of Iowa, Iowa City, IA, USA.
  • Patel SH; Brady Urological Institute, Johns Hopkins, Baltimore, MD, USA.
  • Peak T; Moffitt Cancer Center, Tampa, FL, USA.
  • Peyton CC; Department of Urology, University of Alabama at Birmingham, Birmingham, AL, USA.
  • Pierorazio PM; Department of Urology, University of Pennsylvania, Philadelphia, PA, USA.
  • Prakash G; Department of Urologic Oncology, Tate Memorial Centre, Mumbai, India.
  • Salari K; Massachusetts General Hospital, Boston, MA, USA; Department of Urology, Harvard Medical School, Boston, MA, USA.
  • Sexton WJ; Moffitt Cancer Center, Tampa, FL, USA.
  • Singla N; Brady Urological Institute, Johns Hopkins, Baltimore, MD, USA.
  • Spiess PE; Moffitt Cancer Center, Tampa, FL, USA.
  • Psutka SP; Department of Urology, University of Washington, Seattle, WA, USA; Fred Hutchinson Cancer Center, Seattle, WA, USA.
Eur Urol Focus ; 2024 Aug 14.
Article en En | MEDLINE | ID: mdl-39147634
ABSTRACT
BACKGROUND AND

OBJECTIVE:

There are limited data on the prevalence and management of testicular germ cell tumor (TGCT) cases presenting with venous tumor thrombus (VTT). Our objectives were to describe the prevalence of TGCT with VTT, to identify a multicenter retrospective cohort, and to ascertain expert opinion regarding optimal management of this entity.

METHODS:

Using the IBM Marketscan database, we identified men with testicular cancer who underwent retroperitoneal lymph node dissection (RPLND) with concurrent VTT or inferior vena cava (IVC) tumor thrombectomy to estimate the prevalence of VTT in TGCT. To identify a multicenter retrospective cohort of patients, we surveyed surgeons and described the presentation, management, and outcomes for the cohort. KEY FINDINGS AND

LIMITATIONS:

The prevalence of TGCT with VTT in the IBM Marketscan database was 0.3% (n = 7/2517) when using stringent criteria and 3.1% (n = 79/2517) when using broad criteria. In response to our survey, 16 surgeons from ten centers contributed data for 34 patients. Most patients (n = 29, 85%) presented with nonseminomatous germ cell tumor. Surgical management was used for 93.9% (n = 31), including postchemotherapy tumor thrombectomy with primary cavorrhaphy in 63%. The Marketscan analysis was limited to insured individuals and did not include clinicopathological details, and use of billing codes may have included patients with stromal tumors. In addition, lack of responses to the anonymous survey limited data capture, and the RedCap survey did not address symptoms specific to IVC obstruction or allow central review of the imaging leading to VTT diagnosis. CONCLUSIONS AND CLINICAL IMPLICATIONS VTT among males with TGCT is rare and requires complex multidisciplinary management, including venous tumor thrombectomy at the time of postchemotherapy RPLND. PATIENT

SUMMARY:

Using a medical database, we estimated that the frequency of testicular cancer cases in which the tumor extends into a blood vessel (called venous tumor thrombus, VTT) is just 0.3-3.1%. We carried out a survey of surgeons with experience of this condition. Our results indicate that although testicular cancers respond well to chemotherapy, VTT is less responsive and complex surgery is necessary for this rare condition.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Eur Urol Focus Año: 2024 Tipo del documento: Article Pais de publicación: Países Bajos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Eur Urol Focus Año: 2024 Tipo del documento: Article Pais de publicación: Países Bajos