COMBINED POSTCHEMOTHERAPY RETROPERITONEAL LYMPH-NODE DISSECTION AND RESECTION OF CHEST TUMOR UNDER THE SAME ANESTHETIC IS APPROPRIATE BASEDON MORBIDITY AND TUMOR PATHOLOGY

Purpose: We determine if post-chemotherapy resection of residual retro peritoneal and chest tumor under the same anesthetic is reasonable bas ed on tumor pathology and morbidity, and if the finding of necrosis in the abdomen allows observation of chest tumor. Materials and Methods: We retrospectively reviewed 143 post-chemotherapy patients who underw ent resection of residual retroperitoneal and chest disease under the same anesthetic. Results: Retroperitoneal pathology was generally pred ictive of chest pathology. Concordance existed in 77.5% of patients wi th necrosis, 70% with teratoma and 69% with cancer of the abdomen. How ever, the correlation was much stronger (86%) in predicting necrosis/f ibrosis if cases were categorized as uncomplicated by Indiana Universi ty criteria. Although the morbidity of the combined approach is higher than that of standard post-chemotherapy retroperitoneal lymph node di ssection, it was acceptable. Conclusions: The morbidity of post-chemot herapy retroperitoneal lymph node dissection and resection of chest di sease under the same anesthetic is acceptable. Retroperitoneal patholo gy generally predicts chest pathology but this correlation is much str onger if the case is uncomplicated based on our criteria. In an uncomp licated case the discovery of necrosis of the abdomen allows observati on of chest tumor.