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UP-03.107 Number of Tracts or Stone Size? Which One Influences Outcome of PCNL for Staghorn Renal Stone?
UNMODERATED POSTER SESSIONS
metilen blue or air instillation through the ureteral catheter in 44 cases. Stone fragments migrated into the ureter were extracted using a basket in 54 cases, the flexible endoscopes in 35 cases or pushed up jets of saline under pressure injected through the ureteral catheter. Lumbar palpation after establishing the percutaneous traject allowed the repositioning and extraction of migrated fragments in 54 cases. Conclusions: Technical tricks improved the stone-free rate in a significant number of cases. Their appliance increases proportionally with the surgeon’s experience, but they must be performed with caution, due to the possible associated morbidity.
UP-03.105 Pyelocaliceal Diverticulum: Retrograde Endoscopic Approach of a Rare Pathology Multescu R, Nita G, Georgescu D, Geavlete B, Geavlete P “Saint John” Emergency Clinical Hospital, Bucharest, Romania Introduction and Objectives: The minimally invasive technologies radically changed the management and treatment of pyelocaliceal diverticula. Our goal was to evaluate the efficiency of the retrograde endoscopic approach in this rare pathology. Materials and Methods: Between February 1993 and October 2010, 12 patients with 13 symptomatic pyelocaliceal diverticula (5 of the superior, 3 of the medium and 5 of the inferior calices) were evaluated and treated. Simptomatology included: lumbar pain (10/12 cases), hematuria (4/12 cases) and recurrent urinary tract infections (9/12 cases) with Escherichia Coli and Proteus. A total of 11 patients had intradiverticular lithiasis and one patient presented intradiverticular milk of calcium stone. Nd:YAG laser incision of the diverticular isthmus was attempted in 6 cases, electrosurgical incision in 4 cases and balloon dilation in 2 cases. The electro-hydraulic lithotripsy was performed with 1.6-1.9 F probes. Results: In 9 cases (including the “milk of calcium stone” patient), incision of the narrow isthmus was successful. In the other 3 cases, the failed retrograde incision (especially for the inferior location of the diverticulum) imposed percutaneous approach. The postoperative complications were represented by persistent bleeding (3 cases), fever (one case) and flank pain (3 cases). The postoperative evaluation at 12 months demonstrated a
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large passage between the pyelocaliceal diverticulum and the collecting system in all 9 patients. Conclusions: The minimally invasive procedures with laser incision of the diverticular isthmus may be used as first treatment option. This treatment intends to provide a large non-obstructive communication between the diverticula and the pyelocaliceal system.
UP-03.106 Percutaneous Nephrolithotomy for Staghorn Calculi Nguyen Phuc Cam H, Vu Le C, Le Anh T, Chung Tuan K, Nguyen Viet C Dept. of Urology, Binh Dan Hospital, Ho Chi Minh City, Vietnam Introduction and Objective: Percutaneous nephrolithotomy (PNL) is now performed routinely in our institution. This paper is to introduce our recent series of 16 patients with staghorn calculi undergoing PNL in our centre from December 2006 to March 2010. Materials and Methods: From December 2006 to March 2010 we performed PNL for 16 patients having partial / complete staghorn calculi. After anesthesia, the patient had a cystoscopy for a ureteral catheter placement. Then he was placed into prone position for tract dilation using our modified technique, with supracostal or subcostal access under C-arm. After tract dilation, nephroscopic stone fragmentation using pneumatic lithotriptor and fragments removal using forceps were performed. Placement of a nephrostomy tube at the end of procedure. Postoperative outcomes were assessed with a KUB and / or ultrasonography on discharge. Results: There were 11 male (68.7%) and 5 female (31.3%) patients. Mean age: 46.9 (28-62). Five patients (31.3%) had right side stones and 11 (68.7%) had left side stones. One patient had recurrent stones (6.3%) and 15 had primary stones (93.7%). Mean stone size: 34.12mm (25-40). Eleven patients had complete staghorn calculi (68.7%), 5 patients had partial staghorn calculi (31.3%). Preoperative IVU revealed good renal function in all cases, 1 case with no hydronephrosis (6.25%), 9 cases with mild hydronephrosis (56.25%), and 6 cases with moderate hydronephrosis (37.5%). Three cases with supracostal access (18.75%), 11 cases with subcostal access (68.75%), and 2 cases with combined supracostal and subcostal access with two separate tracts (12.5%). Thirteen cases with only one tract (81.25%), 3 cases with two separate tracts (18.75%).
Two cases with upper calyx puncture (12.5%), 8 cases with middle calyx puncture (50%), 3 cases with lower calyx puncture (18.75%), 2 cases with combined middle and lower calyx puncture (12.5%), 1 case with combined upper and lower calyx puncture (6.25%). Mean operating time: 102.18 mins (60-180). Mean estimated blood loss: 337.5 mL (100-800). Nephrostomy tube removal after 5 days (4-7). Postoperative hospital stay: 5.25 days (4-7). There were 4 cases with important intraoperative bleeding (25%) in which one required stopping the procedure. Two cases required blood transfusion (12.5%). Postoperative outcomes: good (stone-free): 5 cases (31.25%), pretty good (residual fragments ⬍ 5mm): 4 cases (25%), mediocre (residual fragments ⬎ 5mm, multiple fragments): 7 (43.75%) in which 4 cases had extracorporeal shockwave lithotripsy one month postoperatively, 2 cases had second look 1-2 weeks postoperatively for removal of residual fragments, 1 case had second look and extracorporeal shockwave lithotripsy. Conclusions: PNL for staghorn calculi remains a sophisticated renal procedure. Although our initial outcomes were not really satisfactory, this procedure seems feasible and has more optimistic results when combined with extracorporeal shockwave lithotripsy and it can become an alternative to open surgery for staghorn calculi in near future in Vietnam.
UP-03.107 Number of Tracts or Stone Size? Which One Influences Outcome of PCNL for Staghorn Renal Stone? Etemadian M, Maghsoudi R, Shadpour P, Ghasemi H, Radfar M Hasheminejhad Clinical Research Development Center, Hasheminejad Hospital, Tehran, Iran Introduction and Objective: Percutaneous nephrolithtomy is the recommended first line treatment for staghorn stones. To achieve complete stone clearance, PCNL may require using multiple tracts. We aimed to evaluate outcome of PCNL in patients with staghorn calculi, and its correlation with number of tracts and stone features. Materials and Methods: One hundred consecutive patients with staghorn renal stone who underwent PCNL were included in the study. Perioperative and postoperative features were recorded. Correlation of the variables with number of tracts and stone size was assessed. Results: Mean age (⫾standard deviation)
UROLOGY 78 (Supplement 3A), September 2011
UNMODERATED POSTER SESSIONS
was 49.64⫾14.66 years. Mean stone size (⫾standard deviation) was 42.31⫾15.64 mm. Mean number of tracts was 2.4 (range: 3 – 7). Stone free rate was 83%. Stone free rate, hemoglobin depletion, hospital stay, and operation time were not correlated with number of tracts, but with stone size. Conclusion: Percutaneous nephrolithotomy (PCNL) using multiple tracts is effective and safe in achieving stone-clearance rate in patients with staghorn calculi. Most outcome measures are correlated with stone size rather than with number of tracts.
UP-03.108 The Prevalence of Malignancy in NonPalpable Testicular Lesions 10mm or Less in Size Arianayagam R1, Rasiah K1, Vass J1, Lazzaro E1, Vaux K1, Wines M1, Delprado W2, Atmore B3, Chalasani V4 1 Dept. of Urology, Royal North Shore Hospital, St. Leonards, 2Douglass Hanly Moir Pathology, 3Dept. of Anatomical Pathology, Royal North Shore Hospital, St Leonards, 4Clinical Senior Lecturer, NHMRC Clinical Trials Centre, Sydney Medical School, Sydney, Australia Introduction and Objective: Small impalpable testicular lesions (STLs) are increasingly being detected on scrotal ultrasound examination carried out for a variety of indications. Higher rates of diagnosis of STLs can be attributed to growing usage of scrotal ultrasound examination, and the improved resolution provided by ultrasound devices. Management of STLs remains contentious. Guidelines suggest all masses need testicular exploration, with orchidectomy required if tumour is found, or testicular biopsy if the diagnosis of tumour is unclear. Alternatively, previous studies have suggested these lesions can be monitored conservatively. We aim to determine the prevalence of malignancy in small testicular lesions of 10mm or less in size. Materials and Methods: We carried out a retrospective analysis of partial and total orchidectomies carried out by 5 urologists at a tertiary teaching hospital in Sydney, which were performed for suspicious lesions. Our study cohort consisted of 8 consecutive testicular lesions which were 10mm or less in size. All histopathology was reviewed by a uropathologist. We analyzsed this histopathological data to determine the prevalence of malignancy. Results: The average STL size in our series was 8.25mm, with a size range from
6 to 10mm. Patient age ranged from 22 to 81 years of age. Five patients in our series underwent radical orchidectomy and three underwent partial orchidectomy. Of these, we found two mature teratomas, one malignant mixed germ cell tumour, one seminoma, one Leydig cell tumour, one focal scar consistent with germ cell tumour regression, one adenomatoid tumour and one benign simple cyst. Excepting the latter two cases, all of these lesions are malignant or have malignant potential. Conclusion: This study generates the hypothesis that STLs of 10mm or less in size should be treated as per standard lesions and require surgical resection because of the high likelihood of malignancy. Larger prospective studies, which use final histopathology as the gold standard, are required in this area to confirm our preliminary findings.
UP-03.110 Does Cisplatin-based Chemotherapy Effect on Blood Lipid Levels of Patients with Germ Cell Testicular Tumor in Long Term Follow-Up? Koc G, Divrik T, Unlu N, Bulut V, Zorlu F Dept. of Urology, Tepecik Teaching and Research Hospital, Izmir, Turkey Introduction and Objective: Cisplatin based chemotherapy is widely used in the treatment of germ cell testicular tumors. However, long-term complications of this treatment has gained importance, andhypercholesterolemia is one of these. In some studies, hypercholesterolemia is reported following the cisplatin based chemotherapy. In this study we evaluated the relationship of cisplatin basedchemotherapy and blood lipid levels in long-term survivors of patients with germ cell testicular tumors. Materials and Methods: A total of 89 testicular cancer patients were evaluated between December 1989 and December 2001. Of these, while 39 received cisplatin based chemotherapy (Group 1), the remaining control group of 50 testicular cancer patients (Group 2) had no adjuvant treatment. The patients in both groups had at least a five-year follow-up and had no known cardiovascular disease. Fasting lipid profiles were obtained including total cholesterol, triglyceride, low and high density lipoprotein and very low density lipoprotein. These values were compared with the normal range and the statistical difference between the two groups were evaluated. Student’s t test was used for
UROLOGY 78 (Supplement 3A), September 2011
continuous variables and p⬍0.05 was accepted as significant. Results: Group 1 and 2 had 39 and 50 cases, respectively. Mean follow-up period for Group 1 was 110 months (60-187) and 107 months (60-282) for Group 2. Mean total cholesterol in Group 1 and 2 were 199.5 mg/dl ⫾ 44.1 mg/dl and 210.3 mg/dl ⫾ 41 mg/dl (p ⫽ 0.398), mean triglyceride 189.9 mg/dl ⫾ 131.0 mg/dl and 156.6 mg/dl ⫾ 105.5 mg/dl (p ⫽ 0.334), mean high density lipoprotein cholesterol 38.3 mg/dl ⫾ 7.3 and 41.6 mg/dl ⫾ 10.9mg/dl (p ⫽ 0.242) respectively while very low-density lipoprotein cholesterol were 38.2 mg/dl ⫾ 22.1 and 34.6 mg/dl ⫾ 26.7mg/dl (p ⫽ 0.621). The only difference between the two groups was the low density lipoprotein levels. The mean low density lipoprotein cholesterol were 116.6 mg/dl ⫾ 51.7 and 141.9 mg/dl ⫾ 28.1mg/dl (p ⫽ 0.036) respectively. Conclusions: Cisplatin based chemotherapy in germ cell testicular tumors did not have long-term negative effect on blood lipid levels.
UP-03.111 TIN Therapy as Salvage Chemotherapy for Cisplatin Refractory Germ Cell Tumors Nakamura T, Mikami K, Kimura Y, Hongo F, Takaha N, Miki T Kyoto Prefectural University of Medicine, Kyoto, Japan Introduction: The aim of this study was to investigate the efficacy and safeness of paclitaxel (PTX) in combination with ifosphamide (IFM) and nedaplatin (CDGP)(TIN therapy) as salvage chemotherapy for CDDP refractory GCT. Methods: Between August 1998 and September 2009, 67 patients with CDDP refractory GCT were enrolled. Median age was 33 years old (range: 17–52). Median number of previous regimens was 2 (range: 1– 4). The combination chemotherapy consisted of PTX of 175⬃210 mg/m2 on day 1, CDGP of 100 mg/m2 on day 2 and IFM of 1.2 g/m2 on day 2-6 every three weeks. Results: A median of 5 cycles was administered in 67 patients. Grade 3/4 hematologic toxicity was neutropenia in 100% and thrombocytopenia in 95.5%. Response rate in the entire series was 65.7%. Especially, in 14 patients who had TIN therapy as 2nd line therapy, objective response rate was 71.4%. Twenty-six (38.8%) patients achieved no evidence of disease status with a median follow-up of 27 months (2-120 months).
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metilen blue or air instillation through the ureteral catheter in 44 cases. Stone fragments migrated into the ureter were extracted using a basket in 54 cases, the flexible endoscopes in 35 cases or pushed up jets of saline under pressure injected through the ureteral catheter. Lumbar palpation after establishing the percutaneous traject allowed the repositioning and extraction of migrated fragments in 54 cases. Conclusions: Technical tricks improved the stone-free rate in a significant number of cases. Their appliance increases proportionally with the surgeon’s experience, but they must be performed with caution, due to the possible associated morbidity.
UP-03.105 Pyelocaliceal Diverticulum: Retrograde Endoscopic Approach of a Rare Pathology Multescu R, Nita G, Georgescu D, Geavlete B, Geavlete P “Saint John” Emergency Clinical Hospital, Bucharest, Romania Introduction and Objectives: The minimally invasive technologies radically changed the management and treatment of pyelocaliceal diverticula. Our goal was to evaluate the efficiency of the retrograde endoscopic approach in this rare pathology. Materials and Methods: Between February 1993 and October 2010, 12 patients with 13 symptomatic pyelocaliceal diverticula (5 of the superior, 3 of the medium and 5 of the inferior calices) were evaluated and treated. Simptomatology included: lumbar pain (10/12 cases), hematuria (4/12 cases) and recurrent urinary tract infections (9/12 cases) with Escherichia Coli and Proteus. A total of 11 patients had intradiverticular lithiasis and one patient presented intradiverticular milk of calcium stone. Nd:YAG laser incision of the diverticular isthmus was attempted in 6 cases, electrosurgical incision in 4 cases and balloon dilation in 2 cases. The electro-hydraulic lithotripsy was performed with 1.6-1.9 F probes. Results: In 9 cases (including the “milk of calcium stone” patient), incision of the narrow isthmus was successful. In the other 3 cases, the failed retrograde incision (especially for the inferior location of the diverticulum) imposed percutaneous approach. The postoperative complications were represented by persistent bleeding (3 cases), fever (one case) and flank pain (3 cases). The postoperative evaluation at 12 months demonstrated a
S378
large passage between the pyelocaliceal diverticulum and the collecting system in all 9 patients. Conclusions: The minimally invasive procedures with laser incision of the diverticular isthmus may be used as first treatment option. This treatment intends to provide a large non-obstructive communication between the diverticula and the pyelocaliceal system.
UP-03.106 Percutaneous Nephrolithotomy for Staghorn Calculi Nguyen Phuc Cam H, Vu Le C, Le Anh T, Chung Tuan K, Nguyen Viet C Dept. of Urology, Binh Dan Hospital, Ho Chi Minh City, Vietnam Introduction and Objective: Percutaneous nephrolithotomy (PNL) is now performed routinely in our institution. This paper is to introduce our recent series of 16 patients with staghorn calculi undergoing PNL in our centre from December 2006 to March 2010. Materials and Methods: From December 2006 to March 2010 we performed PNL for 16 patients having partial / complete staghorn calculi. After anesthesia, the patient had a cystoscopy for a ureteral catheter placement. Then he was placed into prone position for tract dilation using our modified technique, with supracostal or subcostal access under C-arm. After tract dilation, nephroscopic stone fragmentation using pneumatic lithotriptor and fragments removal using forceps were performed. Placement of a nephrostomy tube at the end of procedure. Postoperative outcomes were assessed with a KUB and / or ultrasonography on discharge. Results: There were 11 male (68.7%) and 5 female (31.3%) patients. Mean age: 46.9 (28-62). Five patients (31.3%) had right side stones and 11 (68.7%) had left side stones. One patient had recurrent stones (6.3%) and 15 had primary stones (93.7%). Mean stone size: 34.12mm (25-40). Eleven patients had complete staghorn calculi (68.7%), 5 patients had partial staghorn calculi (31.3%). Preoperative IVU revealed good renal function in all cases, 1 case with no hydronephrosis (6.25%), 9 cases with mild hydronephrosis (56.25%), and 6 cases with moderate hydronephrosis (37.5%). Three cases with supracostal access (18.75%), 11 cases with subcostal access (68.75%), and 2 cases with combined supracostal and subcostal access with two separate tracts (12.5%). Thirteen cases with only one tract (81.25%), 3 cases with two separate tracts (18.75%).
Two cases with upper calyx puncture (12.5%), 8 cases with middle calyx puncture (50%), 3 cases with lower calyx puncture (18.75%), 2 cases with combined middle and lower calyx puncture (12.5%), 1 case with combined upper and lower calyx puncture (6.25%). Mean operating time: 102.18 mins (60-180). Mean estimated blood loss: 337.5 mL (100-800). Nephrostomy tube removal after 5 days (4-7). Postoperative hospital stay: 5.25 days (4-7). There were 4 cases with important intraoperative bleeding (25%) in which one required stopping the procedure. Two cases required blood transfusion (12.5%). Postoperative outcomes: good (stone-free): 5 cases (31.25%), pretty good (residual fragments ⬍ 5mm): 4 cases (25%), mediocre (residual fragments ⬎ 5mm, multiple fragments): 7 (43.75%) in which 4 cases had extracorporeal shockwave lithotripsy one month postoperatively, 2 cases had second look 1-2 weeks postoperatively for removal of residual fragments, 1 case had second look and extracorporeal shockwave lithotripsy. Conclusions: PNL for staghorn calculi remains a sophisticated renal procedure. Although our initial outcomes were not really satisfactory, this procedure seems feasible and has more optimistic results when combined with extracorporeal shockwave lithotripsy and it can become an alternative to open surgery for staghorn calculi in near future in Vietnam.
UP-03.107 Number of Tracts or Stone Size? Which One Influences Outcome of PCNL for Staghorn Renal Stone? Etemadian M, Maghsoudi R, Shadpour P, Ghasemi H, Radfar M Hasheminejhad Clinical Research Development Center, Hasheminejad Hospital, Tehran, Iran Introduction and Objective: Percutaneous nephrolithtomy is the recommended first line treatment for staghorn stones. To achieve complete stone clearance, PCNL may require using multiple tracts. We aimed to evaluate outcome of PCNL in patients with staghorn calculi, and its correlation with number of tracts and stone features. Materials and Methods: One hundred consecutive patients with staghorn renal stone who underwent PCNL were included in the study. Perioperative and postoperative features were recorded. Correlation of the variables with number of tracts and stone size was assessed. Results: Mean age (⫾standard deviation)
UROLOGY 78 (Supplement 3A), September 2011
UNMODERATED POSTER SESSIONS
was 49.64⫾14.66 years. Mean stone size (⫾standard deviation) was 42.31⫾15.64 mm. Mean number of tracts was 2.4 (range: 3 – 7). Stone free rate was 83%. Stone free rate, hemoglobin depletion, hospital stay, and operation time were not correlated with number of tracts, but with stone size. Conclusion: Percutaneous nephrolithotomy (PCNL) using multiple tracts is effective and safe in achieving stone-clearance rate in patients with staghorn calculi. Most outcome measures are correlated with stone size rather than with number of tracts.
UP-03.108 The Prevalence of Malignancy in NonPalpable Testicular Lesions 10mm or Less in Size Arianayagam R1, Rasiah K1, Vass J1, Lazzaro E1, Vaux K1, Wines M1, Delprado W2, Atmore B3, Chalasani V4 1 Dept. of Urology, Royal North Shore Hospital, St. Leonards, 2Douglass Hanly Moir Pathology, 3Dept. of Anatomical Pathology, Royal North Shore Hospital, St Leonards, 4Clinical Senior Lecturer, NHMRC Clinical Trials Centre, Sydney Medical School, Sydney, Australia Introduction and Objective: Small impalpable testicular lesions (STLs) are increasingly being detected on scrotal ultrasound examination carried out for a variety of indications. Higher rates of diagnosis of STLs can be attributed to growing usage of scrotal ultrasound examination, and the improved resolution provided by ultrasound devices. Management of STLs remains contentious. Guidelines suggest all masses need testicular exploration, with orchidectomy required if tumour is found, or testicular biopsy if the diagnosis of tumour is unclear. Alternatively, previous studies have suggested these lesions can be monitored conservatively. We aim to determine the prevalence of malignancy in small testicular lesions of 10mm or less in size. Materials and Methods: We carried out a retrospective analysis of partial and total orchidectomies carried out by 5 urologists at a tertiary teaching hospital in Sydney, which were performed for suspicious lesions. Our study cohort consisted of 8 consecutive testicular lesions which were 10mm or less in size. All histopathology was reviewed by a uropathologist. We analyzsed this histopathological data to determine the prevalence of malignancy. Results: The average STL size in our series was 8.25mm, with a size range from
6 to 10mm. Patient age ranged from 22 to 81 years of age. Five patients in our series underwent radical orchidectomy and three underwent partial orchidectomy. Of these, we found two mature teratomas, one malignant mixed germ cell tumour, one seminoma, one Leydig cell tumour, one focal scar consistent with germ cell tumour regression, one adenomatoid tumour and one benign simple cyst. Excepting the latter two cases, all of these lesions are malignant or have malignant potential. Conclusion: This study generates the hypothesis that STLs of 10mm or less in size should be treated as per standard lesions and require surgical resection because of the high likelihood of malignancy. Larger prospective studies, which use final histopathology as the gold standard, are required in this area to confirm our preliminary findings.
UP-03.110 Does Cisplatin-based Chemotherapy Effect on Blood Lipid Levels of Patients with Germ Cell Testicular Tumor in Long Term Follow-Up? Koc G, Divrik T, Unlu N, Bulut V, Zorlu F Dept. of Urology, Tepecik Teaching and Research Hospital, Izmir, Turkey Introduction and Objective: Cisplatin based chemotherapy is widely used in the treatment of germ cell testicular tumors. However, long-term complications of this treatment has gained importance, andhypercholesterolemia is one of these. In some studies, hypercholesterolemia is reported following the cisplatin based chemotherapy. In this study we evaluated the relationship of cisplatin basedchemotherapy and blood lipid levels in long-term survivors of patients with germ cell testicular tumors. Materials and Methods: A total of 89 testicular cancer patients were evaluated between December 1989 and December 2001. Of these, while 39 received cisplatin based chemotherapy (Group 1), the remaining control group of 50 testicular cancer patients (Group 2) had no adjuvant treatment. The patients in both groups had at least a five-year follow-up and had no known cardiovascular disease. Fasting lipid profiles were obtained including total cholesterol, triglyceride, low and high density lipoprotein and very low density lipoprotein. These values were compared with the normal range and the statistical difference between the two groups were evaluated. Student’s t test was used for
UROLOGY 78 (Supplement 3A), September 2011
continuous variables and p⬍0.05 was accepted as significant. Results: Group 1 and 2 had 39 and 50 cases, respectively. Mean follow-up period for Group 1 was 110 months (60-187) and 107 months (60-282) for Group 2. Mean total cholesterol in Group 1 and 2 were 199.5 mg/dl ⫾ 44.1 mg/dl and 210.3 mg/dl ⫾ 41 mg/dl (p ⫽ 0.398), mean triglyceride 189.9 mg/dl ⫾ 131.0 mg/dl and 156.6 mg/dl ⫾ 105.5 mg/dl (p ⫽ 0.334), mean high density lipoprotein cholesterol 38.3 mg/dl ⫾ 7.3 and 41.6 mg/dl ⫾ 10.9mg/dl (p ⫽ 0.242) respectively while very low-density lipoprotein cholesterol were 38.2 mg/dl ⫾ 22.1 and 34.6 mg/dl ⫾ 26.7mg/dl (p ⫽ 0.621). The only difference between the two groups was the low density lipoprotein levels. The mean low density lipoprotein cholesterol were 116.6 mg/dl ⫾ 51.7 and 141.9 mg/dl ⫾ 28.1mg/dl (p ⫽ 0.036) respectively. Conclusions: Cisplatin based chemotherapy in germ cell testicular tumors did not have long-term negative effect on blood lipid levels.
UP-03.111 TIN Therapy as Salvage Chemotherapy for Cisplatin Refractory Germ Cell Tumors Nakamura T, Mikami K, Kimura Y, Hongo F, Takaha N, Miki T Kyoto Prefectural University of Medicine, Kyoto, Japan Introduction: The aim of this study was to investigate the efficacy and safeness of paclitaxel (PTX) in combination with ifosphamide (IFM) and nedaplatin (CDGP)(TIN therapy) as salvage chemotherapy for CDDP refractory GCT. Methods: Between August 1998 and September 2009, 67 patients with CDDP refractory GCT were enrolled. Median age was 33 years old (range: 17–52). Median number of previous regimens was 2 (range: 1– 4). The combination chemotherapy consisted of PTX of 175⬃210 mg/m2 on day 1, CDGP of 100 mg/m2 on day 2 and IFM of 1.2 g/m2 on day 2-6 every three weeks. Results: A median of 5 cycles was administered in 67 patients. Grade 3/4 hematologic toxicity was neutropenia in 100% and thrombocytopenia in 95.5%. Response rate in the entire series was 65.7%. Especially, in 14 patients who had TIN therapy as 2nd line therapy, objective response rate was 71.4%. Twenty-six (38.8%) patients achieved no evidence of disease status with a median follow-up of 27 months (2-120 months).
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