PRIMARY RETROPERITONEAL GERM-CELL TUMORS - EXCISION VIA A THORACOABDOMINAL EXTRAPERITONEAL APPROACH

Background Primary retroperitoneal germ cell tumours usually present a s a large abdominal mass in young men. The testes are normal on examin ation and ultrasonography but there are usually raised serum levels of human chorionic gonadotrophin and/or alpha-fetoprotein. Methods Fourt een men (median age 33 years) with primary retroperitoneal germ cell t umours were treated by chemotherapy followed by surgical resection of the primary tumour and metastases via a thoracoabdominal extraperitone al approach. Results There was minimal morbidity. The survival rate wa s 13 of 14 and the disease-free survival rate was 11 of 14 after a med ian follow-up of 15 months. Conclusion The thoracoabdominal extraperit oneal approach for the removal of retroperitoneal germ cell tumours an d their metastases after chemotherapy improves tumour clearance, morbi dity and recovery time compared with the transperitoneal anterior appr oach.