Merlini M, Boumghar M, Berner M, Leyvraz S, Chapuis G
Helv Chir Acta. 1989 Jan;55(5):549-52.
Between 1979 and 1988, iterative surgery was performed on 13 patients for a germ-cell tumor. Apart from orchidectomy, surgery was not the first modality of treatment. On the other hand, 21 surgical procedures were performed for residual tumoral masses after chemotherapy or recurrences. In one third of the cases, only necrosis of fibrosis was resected. Out of 13 patients, 7 died of tumor; 6 are alive (3 with complete remission). Surgery is always indicated in stage IIA to IV nonseminomatous tumors in case of residual tumoral deposits after chemotherapy. For seminoma, surgery is carried out only for retroperitoneal residues larger than 3 cm in diameter. Surgery is also indicated for persistent pulmonary or mediastinal metastases following chemotherapy. Complete surgical excision of residual masses may be technically difficult but is of prime importance as combined chemotherapy and surgery doubles the complete remission rate in comparison to chemotherapy alone.
1979年至1988年间，对13例生殖细胞肿瘤患者进行了多次手术。除睾丸切除术外，手术并非首要治疗方式。另一方面，针对化疗后残留肿瘤肿块或复发情况进行了21次外科手术。三分之一的病例中，仅切除了纤维化坏死组织。13例患者中，7例死于肿瘤；6例存活（3例完全缓解）。对于IIA至IV期非精原细胞瘤，若化疗后有残留肿瘤沉积物，手术总是必要的。对于精原细胞瘤，仅对直径大于3 cm的腹膜后残留病灶进行手术。化疗后持续存在的肺部或纵隔转移瘤也需手术治疗。残留肿块的完整手术切除在技术上可能具有挑战性，但至关重要，因为与单纯化疗相比，联合化疗和手术可使完全缓解率提高一倍。
