腹膜后组织学是否可预测化疗后同期行腹膜后淋巴结清扫术和肝切除术时的肝脏组织学？

Is retroperitoneal histology predictive of liver histology at concurrent post-chemotherapy retroperitoneal lymph node dissection and hepatic resection?

机构信息

Departments of Urology, Surgery and Medicine, Indiana University, Indianapolis, Indiana, USA.

出版信息

J Urol. 2010 Sep;184(3):949-53. doi: 10.1016/j.juro.2010.05.039.

DOI:10.1016/j.juro.2010.05.039

PMID:20643453

Abstract

PURPOSE

We identified factors predicting liver histology in patients with nonseminomatous germ cell tumor undergoing concurrent post-chemotherapy retroperitoneal lymph node dissection and liver resection.

MATERIALS AND METHODS

We reviewed the Indiana University testis cancer database to identify all patients with nonseminomatous germ cell tumor and liver metastasis who underwent post-chemotherapy retroperitoneal lymph node dissection and liver resection between 1976 and 2006.

RESULTS

A total of 59 patients met study inclusion criteria. Necrosis, teratoma and cancer were identified in 31%, 46% and 24% of retroperitoneal specimens, and in 73%, 17% and 10% of liver specimens, respectively. Concordance between retroperitoneal and liver histology was 49% overall, including 94% for necrosis, 26% for teratoma and 36% for cancer. Liver necrosis alone was found in 94%, 70% and 50% of patients with retroperitoneal necrosis, teratoma and cancer, respectively.

CONCLUSIONS

The overall rate of histological discordance between retroperitoneal and liver histology was 51% with 73% of all liver specimens containing necrosis only. Retroperitoneal necrosis is highly predictive of hepatic necrosis (94%). Management for liver lesions at post-chemotherapy retroperitoneal lymph node dissection must be individualized. Observation may be warranted for liver lesions requiring complicated hepatic surgery regardless of retroperitoneal pathology.

摘要

目的

我们确定了同时接受化疗后腹膜后淋巴结清扫术和肝切除术的非精原细胞瘤生殖细胞肿瘤患者的肝组织学预测因素。

材料和方法

我们回顾了印第安纳大学睾丸癌数据库，以确定所有在 1976 年至 2006 年间接受化疗后腹膜后淋巴结清扫术和肝切除术的非精原细胞瘤生殖细胞肿瘤和肝转移患者。

结果

共有 59 名患者符合研究纳入标准。腹膜后标本中分别有 31%、46%和 24%发现坏死、畸胎瘤和癌症，而肝标本中分别有 73%、17%和 10%发现坏死、畸胎瘤和癌症。腹膜后和肝组织学之间的一致性总体为 49%，其中坏死为 94%，畸胎瘤为 26%，癌症为 36%。仅在腹膜后坏死、畸胎瘤和癌症患者中分别有 94%、70%和 50%的患者发现肝坏死。