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Primary Retroperitoneal Lymph Node Dissection for Clinical Stage Ii Seminoma: A Systematic Review and Meta-Analysis of Safety and Oncological Effectiveness Publisher Pubmed



Kardoust Parizi M1, 2 ; Margulis V3 ; Bagrodia A4 ; Bekku K1, 5 ; Klemm J1, 6 ; Matsukawa A1, 7 ; Alimohammadi A1 ; Motlagh RS1 ; Mostafaei H1 ; Laukhtina E1, 8 ; Shariat SF1, 3, 8, 9, 10, 11
Authors
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Authors Affiliations
  1. 1. Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
  2. 2. Department of Urology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, United States
  4. 4. Department of Urology, University of California San Diego, San Diego, CA, United States
  5. 5. Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
  6. 6. Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
  7. 7. Department of Urology, Jikei University School of Medicine, Tokyo, Japan
  8. 8. Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
  9. 9. Department of Urology, Second Faculty of Medicine, Charles University, Prag, Czech Republic
  10. 10. Departments of Urology, Weill Cornell Medical College, New York, NY, United States
  11. 11. Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan

Source: Urologic Oncology: Seminars and Original Investigations Published:2024


Abstract

To evaluate the oncological outcomes and safety of primary retroperitoneal lymph node dissection (RPLND) in patients with clinical stage (CS) II seminomatous testicular germ cell tumor (TGCT). A literature search using PubMed, Scopus, and Cochrane Library was conducted on July 2023 to identify relevant studies according to the Preferred Reporting Items for Systematic Review and Meta Analysis (PRISMA) guidelines. The pooled recurrence rate and treatment-related complications were calculated using a random effects model. Overall 8 studies published between 1997 and 2023 including a total of 355 patients were selected for systematic review and meta-analysis with the overall median follow-up of 38 months. The overall and infield recurrence rate were 0.14 (95% CI: 0.08–0.22) and 0.04 (95% CI: 0.00–0.11), respectively. The overall pooled rate of ≥ Clavien Dindo grade III complications was 0.04 (95% CI: 0.01–0.10); there was no significant heterogeneity (I^2 = 35.10%, P = 0.19). Antegrade ejaculation was preserved with the overall pooled rate of 0.98 (95% CI: 0.95–1.00); there was no significant heterogeneity on Chi-square and I2 tests (I^2 = 0.00%, P = 0.58). Primary RPLND is a safe and effective treatment option for patients with CS II seminomatous TGCT resulting highly promising cure rates combined with low treatment-associated adverse events, at medium-term follow-up. However, owing to the lack of comparative studies to the current standard of care and the limited follow-up, individual decision must be made with the informed patient in a shared decision process together with a multidisciplinary team. © 2024 The Author(s)
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