Taue Ryuich, Harada Akinori, Katto Kazunobu, Yamamoto Yasuyo, Kishimoto Tomoteru, Nakatuji Yoshikazu, Tanimoto Syuuji, Oka Natuo, Izaki Hirofumi, Fukumori Tomoharu, Takahashi Masayuki, Nishitani Masaaki, Kanayama Hiro-omi
The Department of Urology, The University of Tokushima School of Medicine.
Hinyokika Kiyo. 2006 Apr;52(4):293-6.
A 38-year-old patient who had a non-seminomatous testicular cancer was treated by resection of the retroperitoneal metastatic mass that had proven refractory to bleomycin, etoposide and cisplatin (BEP) and paclitaxel, ifosfamide and cisplatin (TIP) chemotherapies. Although salvage chemotherapy was given against the chemorefractory metastatic lesions in the retroperitoneum, the serum alpha-fetoprotein level elevated to 3,252 ng/ml. Retroperitoneal lymph node dissection was performed, and viable cells were identified histopathologically in the resected tissues. The serum AFP level normalized after surgery. No recurrence has been observed for 22 months postoperatively. This experience indicates that salvage surgery even under high serum marker levels may have a beneficial outcome for selected cases of chemotherapy-resistant germ cell tumors.
一名38岁的非精原细胞瘤性睾丸癌患者,其腹膜后转移肿块对博来霉素、依托泊苷和顺铂(BEP)以及紫杉醇、异环磷酰胺和顺铂(TIP)化疗均耐药,遂接受了该转移肿块切除术。尽管针对腹膜后化疗难治性转移病灶进行了挽救性化疗,但血清甲胎蛋白水平仍升至3252 ng/ml。随后进行了腹膜后淋巴结清扫术,病理组织学检查在切除组织中发现了存活细胞。术后血清甲胎蛋白水平恢复正常。术后22个月未观察到复发。这一经验表明,即使在血清标志物水平较高的情况下,挽救性手术对于某些化疗耐药的生殖细胞肿瘤病例可能会产生有益的结果。