BACKGROUND: Since the advent of @entity900 -based chemotherapy, nonseminomatous @entity2971 (NSGCT) have been considered one of the most curable solid @entity5 and a model for multimodality @entity5 therapy. We undertook an institutional review of testicular NSGCT @entity1 who underwent operations to remove lung or mediastinal metastases after chemotherapy in the @entity900 era to determine outcomes. METHODS: From 1980 to 2006, 431 @entity1 underwent 640 postchemotherapy surgical procedures to remove lung (n = 159, 36.8%), mediastinal (n = 136, 31.6%), or both lung and mediastinal (n = 136, 31.6%) metastases within 2 years of chemotherapy. Multiple variables potentially predictive of survival were analyzed. RESULTS: The overall median survival was 23.4 years, with 295 (68%) @entity1 alive and well after an average follow-up of 5.6 years. There was no survival difference in @entity1 who underwent removal of lung or mediastinal metastases. Pathologic categories of resected @entity66 were @entity39 (21.5%), @entity44 (52.7%), persistent NSGCT (15.0%), and @entity5 (10.1%). Multivariable analysis identified older age at time of diagnosis (p = 0.001), non- @entity5 in testes specimen (p = 0.004), and pathology of @entity66 (p < 0.001) as significantly predictive of survival. CONCLUSIONS: @entity1 who undergo resection of residual lung or mediastinal disease for metastatic testicular NSGCT as a planned approach after @entity900 -based chemotherapy have overall excellent long-term survival. Survival is equivalent comparing hematogenous and lymphatic routes of metastases but depends on the pathology of the resected disease. These results justify an aggressive surgical approach, particularly to remove residual @entity44 in the lung or mediastinum after chemotherapy, including multiple surgical procedures if necessary.

Survival after resection for metastatic testicular nonseminomatous XXXX to the lung or mediastinum.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity66 :: ('MESH:D004194', 'Disease') :: ['residual disease'] @entity2971 :: ('MESH:D009373', 'Disease') :: ['germ cell tumors'] @entity5 :: ('MESH:D009369', 'Disease') :: ['germ cell cancer', 'cancer', 'neoplasms', 'degenerative non-germ cell cancer'] @entity39 :: ('MESH:D009336', 'Disease') :: ['necrosis'] @entity900 :: ('MESH:D002945', 'Chemical') :: ['cisplatin'] @entity44 :: ('MESH:D013724', 'Disease') :: ['teratoma']
@entity5 :: (MESH:D009369,Disease) :: ['germ cell cancer']
