Long-term outcome of retroperitoneal lymph node dissection in the management of testis cancer

World Journal of Urology
Stephen D W Beck, Richard S Foster

Abstract

In low volume testicular cancer, (clinical stage A/B1) retroperitoneal lymph node dissection has maintained its therapeutic benefit while minimizing morbidity with the reduction of the surgical template from a full bilateral dissection to a unilateral nerve-sparring surgery. The optimal treatment for low stage disease is largely patient driven with surgery and surveillance considered the primary treatment modalities. In the post chemotherapy population, patients with complete radiographic resolution of retroperitoneal disease are observed at Indiana University as the relapse rate in this population is approximately 5%. Residual masses after chemotherapy should be resected. A modified post chemotherapy dissection is adequate in low volume disease restricted to the primary landing zone of the affected testicle. In chemo-refractory disease, aggressive surgery provides a 5 year survival of 31% for patients with active cancer. Excluding chemo-naïve patients, late relapse disease is managed surgically with 50% being cured of disease.

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Citations

Aug 2, 2012·Therapeutic Advances in Urology·Axel Heidenreich, David Pfister
Mar 5, 2016·Indian Journal of Urology : IJU : Journal of the Urological Society of India·Prabhjot SinghAmlesh Seth
Apr 10, 2010·International Journal of Urology : Official Journal of the Japanese Urological Association·Terukazu Nakamura, Tsuneharu Miki
May 9, 2007·The Urologic Clinics of North America·Robert J Hamilton, Antonio Finelli
May 18, 2018·Oncology Research and Treatment·Axel HeidenreichDavid Pfister
Nov 4, 2020·Expert Review of Anticancer Therapy·Kristyna KozakovaMichal Chovanec
Aug 17, 2018·Annals of Oncology : Official Journal of the European Society for Medical Oncology·F HoneckerA Horwich

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