Abstract：
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.
journal_name
Urologyjournal_title
Urologyauthors
Nielsen ME,Lima G,Schaeffer EM,Porter J,Cadeddu JA,Tuerk I,Kavoussi LRdoi
10.1016/j.urology.2007.08.041subject
Has Abstractpub_date
2007-12-01 00:00:00pages
1168-72issue
6eissn
0090-4295issn
1527-9995pii
S0090-4295(07)02042-0journal_volume
70pub_type
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