Structure of residual metastases in patients with advanced testicular non-seminomatous germ cell tumors and incomplete serological and radiological response to chemotherapy

Objective : to analyze histological structure and identify predictors of detecting malignant non-seminoma in residual tumor masses obtained from patients with testicular non-seminomatous germ cell tumors (TNSGCTs) who had not achieved complete serological radiological response chemotherapy (CT). Materials methods . This study included 96 out 703 TNSGCTs (13.7 %) operated on N.N. Blokhin National Medical Research Center Oncology. The inclusion criteria were as follows: verified advanced TNSGCT, elevated levels alpha-fetoprotein and/or chorionic gonadotropin at the moment CT initiation, least 3 completed courses first-line or second-line platinum-based CT, foci after visualized methods, >7.29 IU/mL >5 mIU/mL weeks initiation last course, surgery CT. Histological examination primary demonstrated that they contained elements seminoma (n = 14; 14.6 %), teratoma 29; 30.2 choriocarcinoma 23; 23.9 embryonal carcinoma 45; 46.9 yolk sac 18; 18.8 %). All participants received CT; 58 them (60.4 also underwent including retroperitoneal lymph node dissection (RPLND) 96; 100 excision extra-retroperitoneal lesions 8; 8.3 Results excised showed areas necrosis fibrosis 25; 26.0 viable 42; 43.8 There was a strong positive correlation between existence components presence (r 0.300; р 0.004), well absence –0.300; invasion metastases into major vessels adjacent organs 0.243; 0.017), prior RPLND 0.413; <0.0001). Patients having ≥3 risk factors significantly more likely have than 0–2 (73.5 % vs 27.3 %; Excised 3; 37.5 1; 12.5 4; 62.5 Concordant observed 4 (50.0 Conclusion Malignant non-seminomas detected tumorsremoved incomplete response. Discordant different locations 50 patients. Our finding can be used select candidates for surgical among these