P-204COMBINED APPROACH FOR RESECTION OF RESIDUAL THORACIC AND RETROPERITONEAL MASSES AFTER CHEMOTHERAPY FOR METASTATIC NON-SEMINOMATOUS GERM CELL TUMOURS
Bibliographic record
Abstract
Resection of residual masses after chemotherapy is advocated for metastatic non-seminomatous germ cell tumours (NSGCT) since residual masses may contain viable tumour and/or teratoma. However, a combined approach for resection of residual thoracic and retroperitoneal disease has rarely been reported. We therefore reviewed our experience to determine the potential advantages of a combined approach to access the abdomen and chest simultaneously. We performed a retrospective review of all patients undergoing thoracic surgery for metastatic NSGCT between January 2005 and Decemer 2012 in our institution. All patients received cisplatin-based chemotherapy before surgery. Out of 48 patients undergoing thoracic surgery for metastatic NSGCT, 20 had a combined approach to the chest and abdomen, 16 had a sequential approach to the chest and abdomen, and 12 had an isolated thoracic procedure. Patients undergoing a combined approach presented predominantly with mediastinal disease (15 out of 20 patients, 75%) while patients undergoing a sequential approach presented more frequently with pulmonary disease alone (11 out of 16 patients, 69%) (P = 0.02). Among patients undergoing a combined approach, the laparotomy was combined with a sternotomy (n = 12), a thoracotomy (n = 5), or a transdiaphragmatic approach (n = 3). The sternolaparotomy was combined with a transpericardial approach to access tumour located below the subcarinal space in the mid visceral mediastinum (n = 5) and/or a transdiaphragmatic approach for tumours located in the lower visceral mediastinum (n = 2). No perioperative death was recorded and all patients were discharged home. At follow-up, 3 patients developed recurrence, including one in the chest. Combined approach to the chest and abdomen for resection of residual masses after chemotherapy for metastatic NSGCT can be safely performed. A sternolaparotomy is particularly beneficial in patients presenting with residual retroperitoneal and mediastinal disease located in the upper, middle and/or lower mediastinum. All authors have declared no conflicts of interest.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".