How do you treat primary retroperitoneal choriocarcinoma with liver and lung metastases and markedly elevated B-HCG?
If no testicular mass on exam or ultrasound - is there a role for orchiectomy? What chemotherapy regimen would you use and how many cycles?
Answer from: Medical Oncologist at Academic Institution
A primary retroperitoneal choriocarcinoma may or may not actually be an occult testis primary, despite the testis being a relative sanctuary site, with normal exam and ultrasound, and no indication for orchiectomy. He has poor risk of disease and needs 4 courses of triple drug therapy, usually with ...
Comments
Medical Oncologist at Case Western Reserve University School of Medicine BHCG dropped from over 500k to 5k after 1 cycle of...
Medical Oncologist at Testicular Cancer Commons As outlined in the JCO Zon paper, HCG decline is n...
Medical Oncologist at Case Western Reserve University School of Medicine Patient had 4 cycles of BEP, B-HCG down to 30s fro...
Medical Oncologist at Testicular Cancer Commons As Dr. @Lawrence H. Einhorn says, I would follow t...
Answer from: Medical Oncologist at Community Practice
Primary retroperitoneal choriocarcinoma is uncommon. The patient is IGCCC poor risk by several criteria. I strongly favor such patients be managed in high volume centers. There are a number of nuances that make this significantly more complex than good/intermediate disease before, during and after c...
Answer from: Medical Oncologist at Academic Institution
I fully agree with @Lawrence H. Einhorn's response. In patients with choriocarcinoma and markedly elevated HCG, there may also be a risk of CNS disease, as well as a risk of "choriocarcinoma syndrome" (rare but important), and thus should be managed very closely especially in the first cycle.
BHCG dropped from over 500k to 5k after 1 cycle of...
As outlined in the JCO Zon paper, HCG decline is n...
Patient had 4 cycles of BEP, B-HCG down to 30s fro...
As Dr. @Lawrence H. Einhorn says, I would follow t...