The role of retroperitoneal lymph node dissection in the management of testicular cancer. Review uri icon

Overview

abstract

  • Despite continued refinement in terms of technique and the integration of retroperitoneal lymph node dissection (RPLND) in the management of patients with testicular cancer, RPLND remains an essential component in the ultimate cure of these patients. The failure to eradicate all disease in the retroperitoneum exposes patients to the risk of late relapse events with potentially lethal consequences. For patients with low-stage nonseminomatous germ cell tumor (NSGCT), primary RPLND is an important staging tool to define subsequent treatment requirements, simplify the follow-up of patients by obviating the need for routine abdominal imaging, and limit the exposure of patients to the long-term toxicity of chemotherapy. RPLND alone is curative in up to 90% of patients with low-volume retroperitoneal disease. In the post-chemotherapy setting, the inability to reliably exclude the presence of teratoma or viable germ cell cancer in the retroperitoneum mandates that post-chemotherapy RPLND be performed for all NSGCT patients with residual masses. With improvements in surgical technique and perioperative care, RPLND is associated with minimal short- and long-term morbidity in the hands of experienced surgeons at dedicated centers. This article reviews the role of RPLND in the management of patients with NSGCT at all stages and its role in advanced seminoma.

publication date

  • January 1, 2004

Research

keywords

  • Germinoma
  • Lymph Node Excision
  • Neoplasm Recurrence, Local
  • Testicular Neoplasms

Identity

Scopus Document Identifier

  • 3242695249

Digital Object Identifier (DOI)

  • 10.1016/j.urolonc.2004.04.029

PubMed ID

  • 15271322

Additional Document Info

volume

  • 22

issue

  • 3