Thoracic metastasectomy for germ cell tumours

Long term survival and prognostic factors

L. Cagini, A. G. Nicholson, A. Horwich, P. Goldstraw, U. Pastorino

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Background: This study evaluated the results of thoracic metastasectomy for germ cell tumours to assess long term survival and identify prognostic factors. Patients and methods: A series of 141 consecutive patients who underwent resection of thoracic metastases at Royal Brompton Hospital were retrospectively reviewed. Kaplan-Meier estimates of survival were calculated for clinical variables related to primary tumour and thoracic metastases, using the Cox model for multivariate analysis. Results: Complete resection was achieved in 123 cases (87%); pathology showed viable malignant elements in 46 (32%), necrosis or fibrosis in 32, differentiated teratoma in 63. The overall survival was 77% at five years and 65% at 15 years, being significantly shorter in patients with malignant teratomatous elements (51% at five years, P = 0.0001) or incomplete resection (64% at five years, P = 0.019). At multivariate analysis these factors retained their prognostic value, with a relative risk of death of 5.7 for malignant teratomatous elements and 4.0 for incomplete resection. In addition, the Cox model revealed a 3.2 times higher risk of relapse in patients with malignant teratomatuos elements at the time of thoracic metastasectomy. Conclusions: These data confirm the value of thoracic metastasectomy to asses pathological response and achieve permanent cure of chemoresistant disease.

Original languageEnglish
Pages (from-to)1185-1191
Number of pages7
JournalAnnals of Oncology
Volume9
Issue number11
DOIs
Publication statusPublished - Nov 1998

Fingerprint

Metastasectomy
Germ Cell and Embryonal Neoplasms
Thorax
Survival
Proportional Hazards Models
Multivariate Analysis
Neoplasm Metastasis
Equidae
Teratoma
Kaplan-Meier Estimate
Fibrosis
Necrosis
Pathology
Recurrence
Neoplasms

Keywords

  • Lung metastases
  • Testicular cancer
  • Thoracic metastasectomies

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Thoracic metastasectomy for germ cell tumours : Long term survival and prognostic factors. / Cagini, L.; Nicholson, A. G.; Horwich, A.; Goldstraw, P.; Pastorino, U.

In: Annals of Oncology, Vol. 9, No. 11, 11.1998, p. 1185-1191.

Research output: Contribution to journalArticle

Cagini, L. ; Nicholson, A. G. ; Horwich, A. ; Goldstraw, P. ; Pastorino, U. / Thoracic metastasectomy for germ cell tumours : Long term survival and prognostic factors. In: Annals of Oncology. 1998 ; Vol. 9, No. 11. pp. 1185-1191.
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