[Exeresis of residual masses of germinal tumors of the testis after chemotherapy]

Abstract

Between 1978 and 1988, amongst the 184 patients treated at the Hôpital du Val de Grâce for a testicular germ cell tumour, 47 patients underwent resection of residual masses after chemotherapy: 27 patients were classified as stage II and 20 were classified as stage III. The chemotherapy, administered for 3 to 6 cycles, used three types of protocols: VAB 6, PVeBV or BEP. Resection of residual masses was only undertaken after return to normal of the biological markers with persistently abnormal medical imaging. Histology of the testicular tumour revealed 3 seminomas and 44 non-seminomatous germ cell tumours. The histology of the residual masses after retroperitoneal lymphadenectomy (42 operations), thoracotomy (9 operations) or craniotomy (1 operation) revealed 22 cases of fibrosis or necrosis (47%), 10 cases of teratoma (21%), 8 cases of cancer (17%) and 7 normal cases (15%). The progression towards fibrosis, necrosis or nature teratoma is synonymous with cure, but the persistence of cancer cells corresponds to a very poor prognosis even after salvage treatment.