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Ninety-one surgical procedures were performed. There were 63 (69 per cent) retroperitoneal lymph node dissections, 16 (18 per cent) thoracotomies, three (3 per cent) hepatic resections, three (3 per cent) craniotomies, five (5 per cent) delayed orchidectomies and one anterolateral decompression of the vertebral column. Nine (13 per cent) patients required a repeat retroperitoneal node dissection and one patient needed a repeat thoracotomy to remove recurrent metastatic deposits during the period of follow-up. Multivisceral resections and vascular reconstruction procedures were required in 20 (30 per cent) patients undergoing retroperitoneal node dissection. Fifty-five (82 per cent) patients remain in complete remission with a mean follow-up period of 49\u00b76 months (range 2\u2013121 months). Nine (13 per cent) patients died with metastatic disease between 2 months to 4 years after operation. There were three deaths in the perioperative period (4 per cent). The histology of the resected metastases revealed undifferentiated active tumour in 20 (30 per cent) patients, differentiated mature teratoma in 29 (43 per cent) patients and fibrosis\/necrosis in 18 (27 per cent) patients. Twelve (60 per cent) patients with undifferentiated elements and 15 patients (60 per cent) with raised preoperative tumour markers (poor prognostic categories) are in complete remission. Cytoreductive surgery in patients with metastatic germ cell tumours offers the best chance of remission following chemotherapy even in poor prognostic group categories.<\/jats:p>","DOI":"10.1002\/bjs.1800780233","type":"journal-article","created":{"date-parts":[[2007,3,3]],"date-time":"2007-03-03T15:14:27Z","timestamp":1172934867000},"page":"226-229","source":"Crossref","is-referenced-by-count":25,"title":["Cytoreductive surgery in disseminated non-seminomatous germ cell tumours of testis"],"prefix":"10.1093","volume":"78","author":[{"given":"R P","family":"Kulkarni","sequence":"first","affiliation":[{"name":"Department of Gastrointestinal Surgery, Charing Cross Hospital , London,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K W","family":"Reynolds","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, Charing Cross Hospital , London,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E S","family":"Newlands","sequence":"additional","affiliation":[{"name":"Cancer Research Campaign Laboratories, Department of Medical Oncology, Charing Cross Hospital , London,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P M","family":"Dawson","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, Charing Cross Hospital , London,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A R","family":"Makey","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, Charing Cross Hospital , London,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N A","family":"Theodorou","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, Charing Cross Hospital , London,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J","family":"Bradley","sequence":"additional","affiliation":[{"name":"Mount Vernon Hospital , Northwood, Middlesex,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R H J","family":"Begent","sequence":"additional","affiliation":[{"name":"Cancer Research Campaign Laboratories, Department of Medical Oncology, Charing Cross Hospital , London,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G J S","family":"Rustin","sequence":"additional","affiliation":[{"name":"Cancer Research Campaign Laboratories, Department of Medical Oncology, Charing Cross Hospital , London,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K D","family":"Bagshawe","sequence":"additional","affiliation":[{"name":"Cancer Research Campaign Laboratories, Department of Medical Oncology, Charing Cross Hospital , London,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[1991,2,1]]},"reference":[{"key":"2024092809410965600_bib1","doi-asserted-by":"crossref","first-page":"293","DOI":"10.7326\/0003-4819-87-3-293","article-title":"Cisdiammedichloroplatinum, vinblastine and bleomycin combination chemotherapy in disseminated testicular cancer","volume":"87","author":"Einhorn","year":"1977","journal-title":"Ann Int Med"},{"key":"2024092809410965600_bib2","doi-asserted-by":"crossref","first-page":"1111","DOI":"10.1016\/S0022-5347(17)54256-1","article-title":"Cytoreductive surgery for metastatic testis cancer: tissue analysis of retroperitoneal masses after chemotherapy","volume":"127","author":"Donohue","year":"1982","journal-title":"J Urol"},{"key":"2024092809410965600_bib3","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1111\/j.1464-410X.1980.tb02917.x","article-title":"The role of surgery in the combined management of metastases from malignant teratomas of the testis","volume":"52","author":"Hendry","year":"1980","journal-title":"Br J Urol"},{"key":"2024092809410965600_bib4","first-page":"407","article-title":"Surgery of disseminated testicular cancer after intensive chemotherapy","volume":"203","author":"Javadpour","year":"1985","journal-title":"Prog Clin Biol Res"},{"key":"2024092809410965600_bib5","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1111\/j.1464-410X.1985.tb07050.x","article-title":"Clinical stage II non-seminomatous germ cell testicular tumours. 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