TY - JOUR
T1 - Oncologic Efficacy of Laparoscopic RPLND in Treatment of Clinical Stage I Nonseminomatous Germ Cell Testicular Cancer
AU - Nielsen, Matthew E.
AU - Lima, Guilherme
AU - Schaeffer, Edward M.
AU - Porter, James
AU - Cadeddu, Jeffrey A
AU - Tuerk, Ingolf
AU - Kavoussi, Louis R.
PY - 2007/12
Y1 - 2007/12
N2 - Objectives: To assess the oncologic efficacy of laparoscopic retroperitoneal lymph node dissection (LRPLND) for clinical Stage I nonseminomatous germ cell tumors (NSGCTs) in a large multi-institutional series. LRPLND is emerging as a less-invasive alternative in the adjuvant surgical treatment of patients with testicular cancer. Methods: The medical records of 120 patients with clinical Stage I NSGCT who underwent LRPLND at one of four institutions in the United States were retrospectively analyzed. All patients had at least 12 months of postoperative follow-up. The modified template dissection was performed at all centers. For the purposes of analysis, the patients were divided into two groups: those with consonant clinical and pathologic Stage I disease (n = 74, 62%) and those upstaged to pathologic Stage II (n = 46, 38%). Results: No patient, including those upstaged to pathologic Stage II disease undergoing surveillance (n = 10), presented with retroperitoneal recurrence after LRPLND. Two patients with consonant pathologic Stage I developed pelvic recurrence that was outside the standard dissection template. The median follow-up for the patients with pathologic Stage I was 28.5 months (range 12 to 144) and was 29 months (range 12 to 108) for those with pathologic Stage II. Conclusions: In this group of patients with clinical Stage I NSGCT, management at multiple institutions that included LRPLND provided excellent intermediate results, paralleling those historically achieved with open lymph node dissection.
AB - Objectives: To assess the oncologic efficacy of laparoscopic retroperitoneal lymph node dissection (LRPLND) for clinical Stage I nonseminomatous germ cell tumors (NSGCTs) in a large multi-institutional series. LRPLND is emerging as a less-invasive alternative in the adjuvant surgical treatment of patients with testicular cancer. Methods: The medical records of 120 patients with clinical Stage I NSGCT who underwent LRPLND at one of four institutions in the United States were retrospectively analyzed. All patients had at least 12 months of postoperative follow-up. The modified template dissection was performed at all centers. For the purposes of analysis, the patients were divided into two groups: those with consonant clinical and pathologic Stage I disease (n = 74, 62%) and those upstaged to pathologic Stage II (n = 46, 38%). Results: No patient, including those upstaged to pathologic Stage II disease undergoing surveillance (n = 10), presented with retroperitoneal recurrence after LRPLND. Two patients with consonant pathologic Stage I developed pelvic recurrence that was outside the standard dissection template. The median follow-up for the patients with pathologic Stage I was 28.5 months (range 12 to 144) and was 29 months (range 12 to 108) for those with pathologic Stage II. Conclusions: In this group of patients with clinical Stage I NSGCT, management at multiple institutions that included LRPLND provided excellent intermediate results, paralleling those historically achieved with open lymph node dissection.
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U2 - 10.1016/j.urology.2007.08.041
DO - 10.1016/j.urology.2007.08.041
M3 - Article
C2 - 18158040
AN - SCOPUS:37349125538
SN - 0090-4295
VL - 70
SP - 1168
EP - 1172
JO - Urology
JF - Urology
IS - 6
ER -