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Testicular Germ Cell Tumors with Venous Tumor Thrombus: Prevalence, Presentation, and Managementстатья
Статья опубликована в высокорейтинговом журнале
Статья опубликована в журнале из списка Web of Science и/или Scopus- Авторы: 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.
- Журнал: European Urology Focus
- Год издания: 2024
- Издательство: Elsevier B.V.
- Местоположение издательства: Netherlands
- DOI: 10.1016/j.euf.2024.07.017
- Аннотация: Background and objectiveThere 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.MethodsUsing 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 limitationsThe 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 implicationsVTT among males with TGCT is rare and requires complex multidisciplinary management, including venous tumor thrombectomy at the time of postchemotherapy RPLND.Patient summaryUsing 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.
- Добавил в систему: Аракелян Геворг Арменович