Six patients underwent surgery while receiving active chemotherapy for metastatic germ cell tumors. Surgical procedures included cholecystectomy, thoracotomy with tumor resection, and orchiectomy. Aggressive chemotherapy was reinitiated immediately after the surgery (average, 4.3 days; range, 3-6 days). Myelosuppression with nadir of granulocytes 80/dL (median) developed at day 13 (average). There were no immediate adverse effects of chemotherapy on wound healing, and all treatment courses were uneventful. We conclude that aggressive chemotherapy can safely be delivered to patients with germ cell tumors immediately after surgery.
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