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Ann Thorac Surg 1984;38:444-446
© 1984 The Society of Thoracic Surgeons

Articles

Thoracotomy as a Staging Procedure after Chemotherapy in the Treatment of Stage III Nonseminomatous Carcinoma of the Testis

K. Prenger, M.D.1, L. Eysman, M.D., J.N. Homan van der Heide, M.D., Ph.D., J. Oldhoff, M.D., Ph.D., D. Th. Sleijfer, M.D., Ph.D., H. Schraffordt Koops, M.D., Ph.D., J.W. Oosterhuis, M.D., Ph.D.

Departments of Thoracic Surgery, Surgical Oncology, Medical Oncology, and Pathology, University Hospital, Groningen, The Netherlands

Accepted for publication January 19, 1984.

1 Address reprint requests to Dr. Prenger, Department of Thoracic Surgery, University Hospital, Oostersingel 59, 9713 EZ Groningen, The Netherlands.

Of 108 patients with a nonseminomatous testicular carcinoma, 28 with lung metastases were studied. After combination chemotherapy with cisplatin, vinblastine, and bleomycin (PVB), 11 patients underwent exploratory thoracotomy. Viable carcinomatous tissue, along with fibrosis, necrosis, and mature teratoma, was found in 4 patients. Three of these patients were successfully retreated with VP 16-213, cisplatin, and actinomycin D. In patients with residual pulmonary or mediastinal masses after chemotherapy, resection of the lesions is mandatory to demonstrate viable carcinoma so that treatment can be readministered. Thus, in our view, thoracotomy is a diagnostic procedure.






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