Oncologic Efficacy of Laparoscopic RPLND in Treatment of Clinical Stage I Nonseminomatous Germ Cell Testicular Cancer

Matthew E. Nielsen, Guilherme Lima, Edward M. Schaeffer, James Porter, Jeffrey A Cadeddu, Ingolf Tuerk, Louis R. Kavoussi

Research output: Contribution to journalArticle

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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.

Original languageEnglish (US)
Pages (from-to)1168-1172
Number of pages5
JournalUrology
Volume70
Issue number6
DOIs
Publication statusPublished - Dec 2007

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ASJC Scopus subject areas

  • Urology

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