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GCT-14. SECOND-LOOK SURGERY FOR INTRACRANIAL GERM CELL TUMORS

OBJECTIVE: The authors present their experiences of second-look surgery in patients with intracranial GCTs who showed less than complete response despite normalizing or decreasing tumor markers after chemotherapy. METHODS: Retrospective review of 14 patients who underwent second-look surgery for an...

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Autor principal: Ogiwara, Hideki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7715579/
http://dx.doi.org/10.1093/neuonc/noaa222.234
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author Ogiwara, Hideki
author_facet Ogiwara, Hideki
author_sort Ogiwara, Hideki
collection PubMed
description OBJECTIVE: The authors present their experiences of second-look surgery in patients with intracranial GCTs who showed less than complete response despite normalizing or decreasing tumor markers after chemotherapy. METHODS: Retrospective review of 14 patients who underwent second-look surgery for an intracranial GCT was performed. RESULTS: Of 40 consecutive patients with newly diagnosed intracranial GCTs treated between August 2003 and 2019, 14 patients (35%) underwent second-look surgery. The mean age was 9.2 years. The initial diagnoses were mixed germ cell tumor in 6, immature teratoma in 4, yolk sac tumor in 2, and germinoma 2. Second-look surgery was performed after 1–3 courses of chemotherapy. Magnetic resonance imaging (MRI) at the surgery demonstrated increasing residual tumor in 8 and stable residual tumor in 6. Tumor markers were normalized in 10 and nearly-normalized in 4. Gross total resection was achieved in 12 patients and near-total resection in 2. Histopatholgy at second-look surgery revealed mature teratoma in 6, immature teratoma in 3, fibrosis with atypical cells in 2, and fibrosis in 3. Eleven patients subsequently underwent additional chemo-radiation therapy according to the initial diagnosis. All patients are alive with no evidence of recurrence with a mean follow-up of 69 months. CONCLUSIONS: Second-look surgery plays an important role in the treatment of intracranial GCTs. Surgery may be encouraged at a relatively early phase after chemotherapy when the residual tumor increases or does not change the size despite normalized or nearly-normalized tumor markers in order to achieve complete resection and improve the outcome.
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spelling pubmed-77155792020-12-09 GCT-14. SECOND-LOOK SURGERY FOR INTRACRANIAL GERM CELL TUMORS Ogiwara, Hideki Neuro Oncol Germ Cell Tumors OBJECTIVE: The authors present their experiences of second-look surgery in patients with intracranial GCTs who showed less than complete response despite normalizing or decreasing tumor markers after chemotherapy. METHODS: Retrospective review of 14 patients who underwent second-look surgery for an intracranial GCT was performed. RESULTS: Of 40 consecutive patients with newly diagnosed intracranial GCTs treated between August 2003 and 2019, 14 patients (35%) underwent second-look surgery. The mean age was 9.2 years. The initial diagnoses were mixed germ cell tumor in 6, immature teratoma in 4, yolk sac tumor in 2, and germinoma 2. Second-look surgery was performed after 1–3 courses of chemotherapy. Magnetic resonance imaging (MRI) at the surgery demonstrated increasing residual tumor in 8 and stable residual tumor in 6. Tumor markers were normalized in 10 and nearly-normalized in 4. Gross total resection was achieved in 12 patients and near-total resection in 2. Histopatholgy at second-look surgery revealed mature teratoma in 6, immature teratoma in 3, fibrosis with atypical cells in 2, and fibrosis in 3. Eleven patients subsequently underwent additional chemo-radiation therapy according to the initial diagnosis. All patients are alive with no evidence of recurrence with a mean follow-up of 69 months. CONCLUSIONS: Second-look surgery plays an important role in the treatment of intracranial GCTs. Surgery may be encouraged at a relatively early phase after chemotherapy when the residual tumor increases or does not change the size despite normalized or nearly-normalized tumor markers in order to achieve complete resection and improve the outcome. Oxford University Press 2020-12-04 /pmc/articles/PMC7715579/ http://dx.doi.org/10.1093/neuonc/noaa222.234 Text en © The Author(s) 2020. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Germ Cell Tumors
Ogiwara, Hideki
GCT-14. SECOND-LOOK SURGERY FOR INTRACRANIAL GERM CELL TUMORS
title GCT-14. SECOND-LOOK SURGERY FOR INTRACRANIAL GERM CELL TUMORS
title_full GCT-14. SECOND-LOOK SURGERY FOR INTRACRANIAL GERM CELL TUMORS
title_fullStr GCT-14. SECOND-LOOK SURGERY FOR INTRACRANIAL GERM CELL TUMORS
title_full_unstemmed GCT-14. SECOND-LOOK SURGERY FOR INTRACRANIAL GERM CELL TUMORS
title_short GCT-14. SECOND-LOOK SURGERY FOR INTRACRANIAL GERM CELL TUMORS
title_sort gct-14. second-look surgery for intracranial germ cell tumors
topic Germ Cell Tumors
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7715579/
http://dx.doi.org/10.1093/neuonc/noaa222.234
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