The role of retroperitoneal lymph node dissection in the management of testicular cancer Journal Article

  


Authors: Stephenson, A. J.; Sheinfeld, J.
Article Title: The role of retroperitoneal lymph node dissection in the management of testicular cancer
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. © 2004 Elsevier Inc. All rights reserved.
Keywords: cancer chemotherapy; surgical technique; treatment failure; cisplatin; cancer risk; conference paper; cancer adjuvant therapy; combined modality therapy; cancer staging; follow up; lymph node metastasis; antineoplastic agent; lymph node dissection; lymph node excision; carboplatin; sensory neuropathy; neoplasm recurrence, local; etoposide; kidney disease; peripheral neuropathy; morbidity; tumor markers, biological; lung cancer; relapse; necrosis; ifosfamide; infertility; fibrosis; testicular neoplasms; imaging; teratoma; perioperative period; orchiectomy; intestine obstruction; testis cancer; germ cell tumor; seminoma; hearing loss; chylous ascites; retroperitoneum; scar; raynaud phenomenon; retroperitoneal space; biological tumor markers; retroperitoneal disease; germinoma; ejaculation disorder; lymphocele; humans; prognosis; human; male; priority journal; neoplasms, germ cell and embryonal/blood/drug therapy/surgery; testicular neoplasms/drug therapy/surgery
Journal Title: Urologic Oncology: Seminars and Original Investigations
Volume: 22
Issue: 3
ISSN: 1078-1439
Publisher: Elsevier Inc.  
Date Published: 2004-05-01
Start Page: 225
End Page: 233
Language: English
DOI: 10.1016/j.urolonc.2004.04.029
PROVIDER: scopus
PUBMED: 15271322
DOI/URL:

http://www.scopus.com/inward/record.url?eid=2-s2.0-3242695249&partnerID=40&md5=4bbdb3d3de510aa8bcaf828ca30b6b31
Notes: Urol. Oncol. Semin. Orig. Invest. -- Cited By (since 1996):39 -- Export Date: 16 June 2014 -- CODEN: UOSOA -- Source: Scopus
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MSK Authors
  1. Andrew James Stephenson
    33 Stephenson
  2. Joel Sheinfeld
    254 Sheinfeld
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