MP73-10 SIMULTANEOUS VERSUS SEQUENTIAL RETROPERITONEAL AND THORACIC RESECTION OF POST CHEMOTHERAPY RESIDUAL MASSES IN PATIENTS WITH METASTATIC NON-SEMINOMATOUS GERM CELL TUMORS OF THE TESTIS
Bibliographic record
Abstract
You have accessJournal of UrologyPenile & Testicular Cancer: Penile & Testicular Cancer III (MP73)1 Apr 2019MP73-10 SIMULTANEOUS VERSUS SEQUENTIAL RETROPERITONEAL AND THORACIC RESECTION OF POST CHEMOTHERAPY RESIDUAL MASSES IN PATIENTS WITH METASTATIC NON-SEMINOMATOUS GERM CELL TUMORS OF THE TESTIS Gregory Nason*, Laura Donahoe, Ishan Aditya, Marc De Perrot, Lynn Anson-Cartwright, Michael Jewett, Aaron Hansen, Philippe Bedard, Padraig Warde, Peter Chung, Joan Sweet, Martin O‘Malley, and Robert Hamilton Gregory Nason*Gregory Nason* More articles by this author , Laura DonahoeLaura Donahoe More articles by this author , Ishan AdityaIshan Aditya More articles by this author , Marc De PerrotMarc De Perrot More articles by this author , Lynn Anson-CartwrightLynn Anson-Cartwright More articles by this author , Michael JewettMichael Jewett More articles by this author , Aaron HansenAaron Hansen More articles by this author , Philippe BedardPhilippe Bedard More articles by this author , Padraig WardePadraig Warde More articles by this author , Peter ChungPeter Chung More articles by this author , Joan SweetJoan Sweet More articles by this author , Martin O‘MalleyMartin O‘Malley More articles by this author , and Robert HamiltonRobert Hamilton More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000557288.44611.92AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: Resection of residual masses (>1cm) after chemotherapy is recommended in patients with testicular non-seminomatous germ cell tumor (NSGCT). Traditionally, resections in the abdomen and chest are performed as separate surgical procedures. The aim of this study was to compare a simultaneous versus a sequential approach to residual mass resections. METHODS: A retrospective review was performed of all patients who underwent both retroperitoneal and thoracic resection of post chemotherapy residual masses at the Princess Margaret Cancer Centre between 2002 and 2018. Patients were divided into two groups: Group 1- Simultaneous (Combined Retroperitoneal and Thoracic resections at the same sitting) Group 2: Sequential (Retroperitoneal and Thoracic resections at separate dates). RESULTS: During the study period, 35 simultaneous and 17 sequential resections were performed. The mean age of patient at surgery was 28 years (Range 16-61). The mean follow up from final surgery was 48.3 months (Range 1-239). Histology revealed teratoma in 38 (73.1%) patients, necrosis in 8 (15.4%) and viable tumor in 6 (11.5%). Discordant pathology findings between thoracic and abdominal resections were noted in 16 (30.8%) patients. There was no difference in overall mean length of operating time (mins) between the two groups (635 mins vs 405 mins + 218 mins, p=0.77). There was no difference in overall blood loss (mls) between the two groups (1904 mls vs 2258mls + 301mls, p=0.39). There was no difference in overall mean length of stay (days) between the two groups (14.8 days vs 9.5 days + 8.2days, p=0.72). Patients who underwent sequential surgeries had a longer time from consent to completion of completion of surgery (8.4 months vs 2.1 months, p=0.0001). Overall, there was a recurrence rate of 30.8% (n=16). Two patients have died of testicular cancer. CONCLUSIONS: Simultaneous resection of retroperitoneal and thoracic post chemotherapy metastases is a feasible and safe approach. It does entail multidisciplinary co-operation and a longer primary procedure. Source of Funding: None. Toronto, Canada© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e1068-e1068 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Gregory Nason* More articles by this author Laura Donahoe More articles by this author Ishan Aditya More articles by this author Marc De Perrot More articles by this author Lynn Anson-Cartwright More articles by this author Michael Jewett More articles by this author Aaron Hansen More articles by this author Philippe Bedard More articles by this author Padraig Warde More articles by this author Peter Chung More articles by this author Joan Sweet More articles by this author Martin O‘Malley More articles by this author Robert Hamilton More articles by this author Expand All Advertisement PDF downloadLoading ...
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| 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 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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 source (direct Gemma or distilled Codex), 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".