A 25-Year Single Institution Experience With Surgery for Primary Mediastinal Nonseminomatous Germ Cell Tumors

Kesler, Kenneth A.; Rieger, Karen M.; Hammoud, Zane T.; Kruter, Laura E.; Perkins, Susan M.; Turrentine, Mark W.; Schneider, Bryan P.; Einhorn, Lawrence H.; Brown, John W.

doi:10.1016/j.athoracsur.2007.09.020

Cited by 113 publications

(112 citation statements)

References 20 publications

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“…If responsive to chemotherapy, the 5-year survival times were above 80% in a recent study [16]. Chemotherapies with bleomycin were more often associated with postoperative respiratory complications and death [14].…”

Section: Discussionmentioning

confidence: 99%

Large mixed germ cell tumor in a young patient presenting as an intrapulmonary mass

Fritzsche

Kristiansen

Frauenfelder

et al. 2009

Pathology - Research and Practice

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Section: Discussionmentioning

confidence: 99%

Large mixed germ cell tumor in a young patient presenting as an intrapulmonary mass

Fritzsche

Kristiansen

Frauenfelder

et al. 2009

Pathology - Research and Practice

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“…This is inferior to those occurring in the retroperitoneum, which are considered IGCCC good or intermediate classification depending on tumor marker status. Surgery plays a vital role in the management of PMNSGCTs as there is a high rate of viable tumor at the time of resection after chemotherapy [44,45]. In general, we advocate that patients with PMNSGCTs are treated initially with VP-16, etopside or vinblastine plus ifosfamide and cisplatin, or another poor-risk cisplatin-based regimen (to avoid bleomycin and its potential pulmonary toxicity) followed by thoracotomy and resection (residual mass is usually present).…”

Section: Extragonadal Germ Cell Tumorsmentioning

confidence: 99%

“…In general, we advocate that patients with PMNSGCTs are treated initially with VP-16, etopside or vinblastine plus ifosfamide and cisplatin, or another poor-risk cisplatin-based regimen (to avoid bleomycin and its potential pulmonary toxicity) followed by thoracotomy and resection (residual mass is usually present). It is important that this complex surgery is undertaken by an experienced thoracic surgeon who has done this type of surgery, assuming the disease is deemed potentially resectable [45]. Because of the lack of effective salvage therapy, resection should be considered even in the face of elevated tumor markers as well as at the time of any recurrence [42,45].…”

Section: Extragonadal Germ Cell Tumorsmentioning

confidence: 99%

“…It is important that this complex surgery is undertaken by an experienced thoracic surgeon who has done this type of surgery, assuming the disease is deemed potentially resectable [45]. Because of the lack of effective salvage therapy, resection should be considered even in the face of elevated tumor markers as well as at the time of any recurrence [42,45].…”

Section: Extragonadal Germ Cell Tumorsmentioning

confidence: 99%

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Postchemotherapy Surgery for Germ Cell Tumors—What Have We Learned in 35 Years?

et al. 2014

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Postchemotherapy surgery for advanced testicular cancer has evolved over the last couple of decades. Patients with nonseminomatous germ cell tumors and residual retroperitoneal mass ≥1 cm should undergo postchemotherapy retroperitoneal lymph node dissection (RPLND). For seminoma, RPLND is considered in those patients with masses ≥3 cm that are also positron emission tomography positive. Masses that occur outside of the retroperitoneum should be completely resected with the possible exception of bilateral lung masses when resection of the first mass shows necrosis. The role of surgery in patients with extragonadal germ cell tumors is most vital in those with primary mediastinal nonseminomatous germ cell tumors. Importantly, patient selection, surgical planning, and consideration of referral to centers with this expertise are important to optimize success.

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“…For instance, for primary mediastinal nonseminomatous germ cell tumors, multimodality treatment is the approach of choice, consisting of neoadjuvant chemotherapy followed by surgical resection of residual disease (32). In thymomas, neoadjuvant chemotherapy and radiotherapy is successful in achieving volume reduction preoperatively (33).…”

Section: Reducing Tumor Sizementioning

confidence: 99%

Management of large mediastinal masses: surgical and anesthesiological considerations

Li¹,

Boven²,

Annema

et al. 2016

J. Thorac. Dis.

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Large mediastinal masses are rare, and encompass a wide variety of diseases. Regardless of the diagnosis, all large mediastinal masses may cause compression or invasion of vital structures, resulting in respiratory insufficiency or hemodynamic decompensation. Detailed preoperative preparation is a prerequisite for favorable surgical outcomes and should include preoperative multimodality imaging, with emphasis on vascular anatomy and invasive characteristics of the tumor. A multidisciplinary team should decide whether neoadjuvant therapy can be beneficial. Furthermore, the anesthesiologist has to evaluate the risk of intraoperative mediastinal mass syndrome (MMS). With adequate preoperative team planning, a safe anesthesiological and surgical strategy can be accomplished.

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A 25-Year Single Institution Experience With Surgery for Primary Mediastinal Nonseminomatous Germ Cell Tumors

Cited by 113 publications

References 20 publications

Large mixed germ cell tumor in a young patient presenting as an intrapulmonary mass

Large mixed germ cell tumor in a young patient presenting as an intrapulmonary mass

Postchemotherapy Surgery for Germ Cell Tumors—What Have We Learned in 35 Years?

Management of large mediastinal masses: surgical and anesthesiological considerations

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