Is Modified Retroperitoneal Lymph Node Dissection Alive for Clinical Stage I Non-Seminomatous Germ Cell Testicular Tumor?

Abstract

Purpose: To evaluate efficacy of modified retroperitoneal lymph node dissection (RPLND) in themanagement of patients with pathological stage (PS) I non-seminomatous germ cell testicular tumor(NSGCT) in a retrospective study.Materials and Methods: Between April 2002 and April 2012, 55 patients with clinical stage (CS)I NSGCT had undergone modified RPLND according to Sloan-Kettering modified RPLND template.Clinicopathological parameters, retroperitoneal relapse, and antegrade ejaculation rate wereevaluated in patients with PS I.Results: Of 55 patients, 41 (74.5%) and 14 (25.5%) subjects were in PS I and II, respectively. InPS I group, the mean patients’ age was 32.8 years (range, 19 to 51 years) at the end of the follow-upperiod. Three patients missed the follow-up; hence, were excluded from the study. Mean follow-upduration was 56 months (range, 6 to 120 months). Tumor recurrence was identified in no subjectsat the end of the follow-up period. Overall peri and postoperative complication rate was 18% (7 patients).Out of 38 patients, 23 (61%) had post RPLND antegrade ejaculation at the end of the study.Conclusion: Modified template RPLND is a safe, effective, and sufficient treatment for patientswith no retroperitoneal micrometastasis after the procedure. Furthermore, this strategy may obviatethe need for close, expensive, and potentially harmful follow-up protocol in patients with PS INSGCT.

Keywords

• lymph node excision
• testicular neoplasms
• neoplasm metastasis