Chances for relapse after 4xchemo and PC-RPLND??

[Vaan]

Hi Tark!
Thanks for your comment. His surgeon who is very experienced working for an Europian reference center in RPLND in Cologne saw the images and compared to the previous. His answer was that this is only a slight increase and only if the totals increase is more than 25% we should worry. I trust him and taking into account that dr E also agree with this procedure I don't worry. Maybe, if I had to decide I would prefer to the it out.. just for peace of mind! But I don't want to tell my husband something that it will make him anxious since the experts haven't mention it yet.

[Tarc79]

If it is surgically possible, I'd tell your surgeon to take that node out. Surely, there may be some other risks involved as to why they didn't do this in the first place, but given the size increase and the original size itself, why would you want to take a chance? This will also ease your mind and allow to get back to your normal life faster. IMHO.

[Vaan]

That was the original size. In the previous scan was slightly smaller and now is approximately 5x4,7. if the biopsy of one mass shows necrotic tissue they don't remove the other. I had the confirmation of D E for this practice so I don't have doubts that they do the right procedure, taking into account and the effects of bilateral RPLND and the difficulty of the procedure.
But now it makes me really upset the fact that the mass is getting bigger!! They also did a quick biopsy in the remaining mass during the surgery which shows only necrotic tissue.
Any ideas??

[Davepet]

The size of the mass was about 4x4 cm.

Is that the original size when the surgery was done or the new size at this scan. It seems odd to me that they didn't go ahead & take it out while they had him open.

Dave

[Vaan]

The size of the mass was about 4x4 cm.

[JeskiM69]

What size was the node before this scan ? What size is it now ?

Markers being negative are a good sign.

- Matt

[Vaan]

Hello to everybody!
Yesterday my husband had his follow up scans and blood markers! Unfortunately the radiologist saw an increase in his remaining mass (about 5 mm). He had two masses one in the left and one in the right. During his PC-RPLND they remove only the left mass since the quick biopsy from both masses shown only necrotic tissue. His markers are still negative. Could this increase indicate a relapse??

[jpboucher]

Hey vaan,

Indeed, I would be also surprised if the medical literature will gave us an answer on this question. I searched a little and found not so much interesting data. There are so much different presentations, IGCCCG group presentation, histology of the tumor type, etc.

With pure EC, some authors report as much as 90 % of complete response to chemo. MSKCC in New York found a 7 % presence of teratoma after chemo with pure EC. Still, those case reports are for stage II and III, so they maybe not representative of stage IIIB TC alone.

But my gut feeling says that with only necrosis found, maybe the greatest risk of "relapse", although not a relapse, is the 2 - 5 % risk of having a new TC in the controlateral testis.

jp

[Vaan]

Thanks Dave. I also hope so!

[Davepet]

Realistically, stage III is fairly rare, and stage III with his particular types of growth even more so. I would be surprised if there were any statistically significant studies matching his case. I could be wrong.That he is 6 months out of chemo, markers normal after 2 rounds, & had surgery confirming no active cancer is all very encouraging. hoping the good news continues.

Dave

[Vaan]

Thanks Dave for your response! I am wondering if anyone else has seen a research or more specific information about this matter.
Thanks a lot!

[Davepet]

Only time will tell for sure, but the early results seem to be positive, so I think his odds are pretty good.

Fingers crossed!

Dave

[Vaan]

Hi to everybody!
Some of you may already know about my story. In brief, my husband has been diagnosed with TC IIIB 100% EC back in 3/2016. He had two huge masses one in his left retroperitoneal area and one right retrocrural. He finished his chemo (2xBEP 2xVIP) in 6/2016 and his markers were normalized since the end of his second round. In 9/2016 he had his PC-RPLND. They remove only the left retroperitoneal mass and the biopsy showed only necrosis. The biopsy from retrocrural mass showed necrosis too, so the doc said that it was not necessary to be resected.
Unfortunately sometimes I feel that I can't manage this situation and I am afraid of a possible relapse. Surveillance makes me really anxious. Please let me know about your opinion regarding the chances of relapse?? Are the chances for cure good in that case?
Thanks a lot.