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Postchemotherapy Retroperitoneal Lymph Node Dissection in Patients With Nonseminomatous Testicular Cancer: A Single Center Experiences Publisher



Nowroozi M1 ; Ayati M1 ; Arbab A1 ; Jamshidian H1 ; Ghorbani H2 ; Niroomand H1 ; Mahmoodi MT1 ; Amini E1 ; Salehi S2 ; Hakima H2 ; Fazeli F1 ; Haghdani S3 ; Ghadian A4
Authors
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Authors Affiliations
  1. 1. Uro-Oncology Research Center, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Urology, Qazvin University of Medical Sciences, Qazvin, Iran
  3. 3. Department of Urology, Shahid Hasheminejad Hospital, Iran University of Medical Sciences, Tehran, Iran
  4. 4. Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran

Source: Nephro-Urology Monthly Published:2015


Abstract

Background: Testicular cancer accounts for about 1 - 1.5% of all malignancies in men. Radical orchiectomy is curative in 75% of patients with stage I disease, but advance stage with retroperitoneal lymph node involvement needs chemotherapy. All patients who have residual masses ≥ 1 cm after chemotherapy should undergo postchemotherapy retroperitoneal lymph node dissection (PC-RPLND). Objectives: Treatment of advanced nonseminomatous testicular cancer is usually a combination of chemotherapy and surgery. We described our experience about postchemotherapy retroperitoneal lymph node dissection (PC-RPLND) in our center. Patients and Methods: In a retrospective cross-sectional study between 2006 and 2011, patients with a history of postchemotherapy retroperitoneal lymph node dissection (PC-RPLND) in Imam Khomeini hospital were evaluated. All patients had normal postchemotherapy serum tumor markers and primary nonseminomatous cancer. We reviewed retrospectively clinical, pathological, and surgical parameters associated with PC-RPLND in our center. Results: Twenty-one patients underwent bilateral PC-RPLND. Mean age was 26.3 years (ranged 16 - 47). Mean size of retroperitoneal mass after chemotherapy was 7.6 cm. Mean operative time was 198 minutes (120 - 246 minutes). Mean follow-up time was 38.6 months. Pathologic review showed presence of fibrosis/necrosis, viable germ cell tumor and teratoma in 8 (38.1%), 10 (47.6%) and 3 (14.28%) patients, respectively. One patient in postoperative period of surgery and three patients in two first years after surgery were expired. Of 17 alive patients, only two (11.8%) had not retrograde ejaculation. Conclusions: PC-RPLND is one the major operations in the field of urology, which is associated with significant adjunctive surgeries. In appropriate cases, PC-RPLND was associated with good cancer specific survival in tertiary oncology center. © 2015, Nephrology and Urology Research Center.