具有静脉肿瘤血栓的睾丸生殖细胞肿瘤：患病率，表现和管理

关于静脉肿瘤血栓（VTT）的睾丸生殖细胞肿瘤（TGCT）病例的患病率和管理的数据有限。 Our objectives were to describe the prevalence of TGCT with VTT, to identify a multicenter retrospective cohort, and to ascertain expert opinion regarding optimal management of this entity.Using the IBM Marketscan database, we identified men with testicular cancer who underwent retroperitoneal lymph node dissection (RPLND) with concurrent VTT or inferior vena cava (IVC) tumor thrombectomy估计VTT在TGCT中的普遍性。为了确定多中心回顾性患者的群体，我们调查了外科医生并描述了同类群体的表现，管理和结果。当使用严格的标准和3.1％（n = 79/2517）时，IBM MarketScan数据库中TGCT与VTT的患病率为0.3％（n = 7/2517）。为了应对我们的调查，来自10个中心的16名外科医生为34例患者提供了数据。大多数患者（n = 29，85％）出现了非膜质性生殖细胞肿瘤。手术治疗使用93.9％（n = 31），包括63％的化学后疗法肿瘤血栓切除术和原发性cavorrhaphy。市场范围的分析仅限于保险人，不包括临床病理细节，使用计费代码可能包括基质肿瘤患者。此外，缺乏对匿名调查的反应有限的数据捕获，并且REDCAP调查并未解决IVC障碍物特有的症状，或者允许对导致VTT诊断的成像进行中心审查。VTT很少见，vtt很少见，需要复杂的多学科管理，包括静脉肿瘤的静脉治疗，包括在验证后的频率频率。肿瘤延伸到血管（称为静脉肿瘤血栓，VTT）仅为0.3-3.1％。我们对具有这种状况经验的外科医生进行了调查。我们的结果表明，尽管睾丸癌对化学疗法的反应很好，但VTT的反应较差，对于这种罕见状况而言，需要复杂的手术。

There are limited data on the prevalence and management of testicular germ cell tumor (TGCT) cases presenting with venous tumor thrombus (VTT). Our objectives were to describe the prevalence of TGCT with VTT, to identify a multicenter retrospective cohort, and to ascertain expert opinion regarding optimal management of this entity.Using the IBM Marketscan database, we identified men with testicular cancer who underwent retroperitoneal lymph node dissection (RPLND) with concurrent VTT or inferior vena cava (IVC) tumor thrombectomy to estimate the prevalence of VTT in TGCT. To identify a multicenter retrospective cohort of patients, we surveyed surgeons and described the presentation, management, and outcomes for the cohort.The prevalence of TGCT with VTT in the IBM Marketscan database was 0.3% (n = 7/2517) when using stringent criteria and 3.1% (n = 79/2517) when using broad criteria. In response to our survey, 16 surgeons from ten centers contributed data for 34 patients. Most patients (n = 29, 85%) presented with nonseminomatous germ cell tumor. Surgical management was used for 93.9% (n = 31), including postchemotherapy tumor thrombectomy with primary cavorrhaphy in 63%. The Marketscan analysis was limited to insured individuals and did not include clinicopathological details, and use of billing codes may have included patients with stromal tumors. In addition, lack of responses to the anonymous survey limited data capture, and the RedCap survey did not address symptoms specific to IVC obstruction or allow central review of the imaging leading to VTT diagnosis.VTT among males with TGCT is rare and requires complex multidisciplinary management, including venous tumor thrombectomy at the time of postchemotherapy RPLND.Using a medical database, we estimated that the frequency of testicular cancer cases in which the tumor extends into a blood vessel (called venous tumor thrombus, VTT) is just 0.3-3.1%. We carried out a survey of surgeons with experience of this condition. Our results indicate that although testicular cancers respond well to chemotherapy, VTT is less responsive and complex surgery is necessary for this rare condition.