Results of retroperitoneal lymph node dissection for clinical stage I and II pure embryonal carcinoma of the testis Journal Article
| Authors: | Pohar, K. S.; Rabbani, F.; Bosl, G. J.; Motzer, R. J.; Bajorin, D.; Sheinfeld, J. |
| Article Title: | Results of retroperitoneal lymph node dissection for clinical stage I and II pure embryonal carcinoma of the testis |
| Abstract: | Purpose: We determined the pathological findings and clinical outcome of patients with pure embryonal carcinoma (EC) of the testis managed by primary retroperitoneal lymph node dissection. Materials and Methods: From January 1989 to February 1998, 45 patients with pure EC underwent primary retroperitoneal lymph node dissection at our institution. Patients presented as clinical stage I in 26, IIA in 17 and IIB in 2. Lymphovascular invasion was present in 29 (64%). Median followup was 36.8 months. Results: Overall the pathological stage was pN0 in 11, pN1 in 10 (4 with microscopic disease) and pN2/N3 in 24 patients (8 with extranodal extension). Nineteen of 26 patients (73%) with clinical stage I and 13 of 17 (77%) patients with clinical stage IIA had retroperitoneal disease. No patient with negative lymph nodes (pN0) has had relapse. Only 1 of 9 (11%) patients with pN1 treated without adjuvant chemotherapy has had relapse. Of 24 patients with pN2/N3 disease only 3 (12%) have required more than 2 cycles of postoperative chemotherapy for persistent or recurrent disease despite complete resection of the retroperitoneum. Conclusions: Patients with low stage pure EC of the testis are at high risk for retroperitoneal disease. However these patients do not appear to be at increased risk for high volume (pN2/N3) retroperitoneal disease, systemic relapse in pN0 or pN1 disease managed without adjuvant chemotherapy (although the number of evaluable patients in this subset is somewhat small), or persistent or recurrent disease in completely resected high volume (pN2/N3) retroperitoneal disease compared to patients with mixed nonseminomatous germ cell tumors. |
| Keywords: | clinical article; controlled study; cancer recurrence; cisplatin; paclitaxel; cancer adjuvant therapy; postoperative care; cancer staging; follow up; follow-up studies; lymph node dissection; paraaortic lymph node; neoplasm staging; lymph node excision; ifosfamide; high risk patient; cancer invasion; testicular neoplasms; germ cell tumor; embryonal carcinoma; retroperitoneal space; retroperitoneal disease; testis carcinoma; carcinoma, embryonal; humans; human; male; priority journal; article; lymph node excision, retroperitoneal space |
| Journal Title: | Journal of Urology |
| Volume: | 170 |
| Issue: | 4 pt. 1 |
| ISSN: | 0022-5347 |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2003-10-01 |
| Start Page: | 1155 |
| End Page: | 1158 |
| Language: | English |
| DOI: | 10.1097/01.ju.0000087796.63505.70 |
| PUBMED: | 14501714 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Export Date: 12 September 2014 -- Source: Scopus |
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