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ISSN: 2641-1687

Journal of Urology & Nephrology Studies

Research Article(ISSN: 2641-1687)

Clinical Features, Treatment, and Outcome of Tumor Lysis Syndrome in Germ Cell Tumors

Volume 1 - Issue 4

Bryan Leung1, Jeffrey Wang2, Jill Cassaday3 and Jue Wang3*

  • Author Information Open or Close
    • 1Department of Pharmacy
    • 2Baylor College of Medicine
    • 3Professor of Medicine, Director of Genitourinary Oncology Section, USA

    *Corresponding author: Jue Wang, MD, FACP, Professor of Medicine, Director of Genitourinary Oncology Section, University of Arizona Cancer Center at Dignity Health St. Joseph’s, Phoenix, AZ 85004

Received: December 20, 2018;   Published: January 04, 2019

DOI: 10.32474/JUNS.2019.01.000116

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Abstract

Background: Tumor lysis syndrome (TLS) is an oncologic emergency that can occur spontaneously or triggered by cancer treatment. This life-threatening condition is most commonly seen in hematologic cancers but is sometimes described in solid tumors such as germ cell tumors (GCTs). The objective of this study is to investigate the clinical characteristics and outcomes of TLS in GCTs.

Methods: Retrospective review and pooled analysis.

Result: Seventeen cases of TLS related to GCTs were identified. These included nonseminomatous GCT (7), seminoma (5), choriocarcinoma (2), ovarian (2), and intracranial germinoma (1). Nine cases (53%) of TLS were treatment-related and eight cases (47%) occurred spontaneously. The median age of patients was 34 years (range: 13-58), excluding one newborn baby. The median time from treatment to TLS was 2.1 days. Seven patients (41%) had liver metastases, but all patients had bulky disease. All of the patients received supportive measures; 4 (24%) patients received rasburicase and 11 patients (64%) underwent hemodialysis. The mortality rate was 44.4% among the nine cases of treatment-related TLS. The mortality rate was 37.5% in the eight patients with spontaneous TLS (STLS).

Conclusion: TLS can occur in GCTs that have a high tumor burden. Almost 50% of TLS in GCTs happened spontaneously. Considering the life-threatening nature of TLS in GCTs, health professionals should be alert and monitor for TLS in order to prevent or treat this potentially fatal complication.

Keywords: Tumor lysis syndrome (TLS); Oncologic emergency; Germ cell tumors (GCTs); Clinical features, Treatment, and Outcome; Mortality

Abstract| Introduction| Material and Methods| Results| Discussion| Conclusion| Declaration| References|

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