Ann Thorac Surg 2000;69:343-344
© 2000 The Society of Thoracic Surgeons
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Discussion
DR KENNETH A. KESLER (Indianapolis, IN): During the past 16 years, at Indiana University, we have treated 91 patients, the vast majority of whom received cisplatinum and VP16 chemotherapy regimens. This has been established as standard chemotherapy for germ cell cancers by Dr Lawrence Einhorn at our institution, and utilized as primary chemotherapy at most cancer centers worldwide.Seventy-nine of these patients ultimately presented for operation. Just under 60% are alive at 5 years, and approximately 50% are still surviving after 10 years of follow-up. Doctor Walsh and his colleagues report 10 patients that have had complete 2-year follow-up after undergoing operations, 8 of which are still alive, which represents 80% survival, as compared to approximately 70% in our series. This difference seems even more impressive given the fact that Dr Walsh and his colleagues report a very high percentage of patients with extra mediastinal disease, as well as patients that have undergone salvage chemotherapy. Given the low numbers of patients in their series and relatively brief follow-up, however, one wonders if this difference is really significant, particularly since these patients are known to be at constant risk for death secondary to late relapses as well as hematologic malignancies.
In our series, it was not surprising to find the patients that demonstrate tumor necrosis only or benign teratoma in their pathologic specimen, had excellent and good long-term survival, respectively, as compared to patients with pathology demonstrating persistent . . . [Full Text of this Article]
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Intensive chemotherapy and radical resections for primary nonseminomatous mediastinal germ cell tumors
- Garrett L. Walsh, Grant D. Taylor, Jonathan C. Nesbitt, and Robert J. Amato
Ann. Thorac. Surg. 2000 69: 337-343.
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Copyright © 2000 by The Society of Thoracic Surgeons.
