Accelerated growth of testicular cancer after cytoreductive surgery

Abstract

Surgical removal of bulky metastases of non-seminomatous germ-cell testicular cancer has been advocated as an adjuvant to chemotherapy in patients whose disease probably is too extensive to be cured by chemotherapy or surgery alone. However, in 8 of our patients, cytoreductive surgery was followed by a sudden and dramatic exacerbation of the disease. In some cases, a marked rise in the serum levels of alpha-fetoprotein and human chorionic gonadotropin was the only evidence. The cause and prevalence of such exacerbations are unknown. Cytoreductive surgery in patients with advanced testicular tumor is accepted treatment and should be advocated, but it appears that in some cases such surgery may adversely alter the course of the malignancy. This must be considered in planning treatment for patients with advanced disease.

Plasma chitinase 3-like 1 is persistently elevated during first month after minimally invasive colorectal cancer resection

“…The medical literature contains numerous case reports of rapid growth of residual metastases after major surgery [7][8][9] . In particular, rapid growth of preexisting metastatic cancer in the liver after resection of the primary colorectal tumor has been noted by several investigators [6,[50][51][52] .…”

“…Murine studies have shown those laparotomy and bowel resections are associated with increased tumor growth and establishment vs results in anesthesia control mice [3][4][5] . In humans, numerous case reports have noted increased tumor growth soon after surgery in patients with residual cancer [6][7][8][9] . A number of mechanisms, including surgery-related immunosuppression and the removal of primary tumor generated anti-angiogenic factors, have been proposed to account for accelerated tumor growth after surgery [10,11] .…”

Concomitant Tumor Resistance: The Role of Tyrosine Isomers in the Mechanisms of Metastases Control

“…Concerning the relevance of CR for mechanisms of metastasis control, it has been observed that the removal of human and murine tumors may be followed by an abrupt increase in metastatic growth (9)(10)(11)(12)(13)(14)(15)(16). This suggests that in certain circumstances, the primary tumor exerts a controlling action on its metastases, which can be considered as secondary tumor implants that developed spontaneously during the primary tumor growth.…”

“…The above clinical studies, together with similar investigations carried out with patients affected by similar or other malignancies, strongly suggest that sudden acceleration of metastases may be an undesired outcome of surgical removal of many common human malignancies, including primary melanomas and breast, testicular, ovarian, lung, colorectal, and bladder cancers (9,10,16,(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33).…”

Differential production of angiostatin by concomitant antitumoral resistance‐inducing cancer cells

“…1 The first of the cases mentioned above, observed not only in clinical [2][3][4][5] but also in experimental 6 -12 situations, suggests that some primary tumors are capable of inhibiting the growth of secondary tumors or metastases. This phenomenon was described at the beginning of 20th century by Ehrlich 13 and was designated as concomitant immunity by Bashford,14 assuming that it could be explained by immunologic means.…”