Twenty Years’ Experience in Retroperitoneal Lymph Node Dissection for Testicular Cancer in a Tertiary Referral Center
<i>Background and Objectives</i>: The aim of this article is to present a single-surgeon, open retroperitoneal lymph node dissection (RPLND) series for testicular cancer in a high-volume center. <i>Materials and Methods</i>: We reviewed data from patients who underwent RPLND...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-01-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/59/1/133 |
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| author | Angelo Mottaran Amelio Ercolino Lorenzo Bianchi Pietro Piazza Francesco Manes Sasan Amirhassankhani Marco Salvador Francesco Chessa Beniamino Corcioni Alessandro Bertaccini Riccardo Schiavina Eugenio Brunocilla |
| author_facet | Angelo Mottaran Amelio Ercolino Lorenzo Bianchi Pietro Piazza Francesco Manes Sasan Amirhassankhani Marco Salvador Francesco Chessa Beniamino Corcioni Alessandro Bertaccini Riccardo Schiavina Eugenio Brunocilla |
| author_sort | Angelo Mottaran |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: The aim of this article is to present a single-surgeon, open retroperitoneal lymph node dissection (RPLND) series for testicular cancer in a high-volume center. <i>Materials and Methods</i>: We reviewed data from patients who underwent RPLND performed by an experienced surgeon at our institution between 2000 and 2019. We evaluated surgical and perioperative outcomes, complications, Recurrence-Free Survival (RFS), Overall Survival (OS), and Cancer-Specific Survival (CSS). <i>Results</i>: RPLND was performed in primary and secondary settings in 21 (32%) and 44 (68%) patients, respectively. Median operative time was 180 min. Median hospital stay was 6 days. Complications occurred in 23 (35%) patients, with 9 (14%) events reported as Clavien grade ≥ 3. Patients in the primary RPLND group were significantly younger, more likely to have NSGCT, had higher clinical N0 and M0, and had higher nerve-sparing RPLND (all <i>p</i> ≤ 0.04) compared to those in the secondary RPLND group. In the median follow-up of 120 (56–180) months, 10 (15%) patients experienced recurrence. Finally, 20-year OS, CSS, and RFS were 89%, 92%, and 85%, respectively, with no significant difference in survival rates between primary vs. secondary RPLND subgroups (<i>p</i> = 0.64, <i>p</i> = 0.7, and <i>p</i> = 0.31, respectively). <i>Conclusions</i>: Open RPLND performed by an experienced high-volume surgeon achieves excellent oncological and functional outcomes supporting the centralization of these complex procedures. |
| first_indexed | 2024-03-09T11:44:05Z |
| format | Article |
| id | doaj.art-0013cb7a26e147bd8620c04b15269834 |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-09T11:44:05Z |
| publishDate | 2023-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-0013cb7a26e147bd8620c04b152698342023-11-30T23:24:48ZengMDPI AGMedicina1010-660X1648-91442023-01-0159113310.3390/medicina59010133Twenty Years’ Experience in Retroperitoneal Lymph Node Dissection for Testicular Cancer in a Tertiary Referral CenterAngelo Mottaran0Amelio Ercolino1Lorenzo Bianchi2Pietro Piazza3Francesco Manes4Sasan Amirhassankhani5Marco Salvador6Francesco Chessa7Beniamino Corcioni8Alessandro Bertaccini9Riccardo Schiavina10Eugenio Brunocilla11Division of Urology, IRCCS Azienda Ospedaliero—Universitaria di Bologna, 40138 Bologna, ItalyDivision of Urology, IRCCS Azienda Ospedaliero—Universitaria di Bologna, 40138 Bologna, ItalyDivision of Urology, IRCCS Azienda Ospedaliero—Universitaria di Bologna, 40138 Bologna, ItalyDivision of Urology, IRCCS Azienda Ospedaliero—Universitaria di Bologna, 40138 Bologna, ItalyDivision of Urology, IRCCS Azienda Ospedaliero—Universitaria di Bologna, 40138 Bologna, ItalyDivision of Urology, IRCCS Azienda Ospedaliero—Universitaria di Bologna, 40138 Bologna, ItalyDivision of Urology, IRCCS Azienda Ospedaliero—Universitaria di Bologna, 40138 Bologna, ItalyDivision of Urology, IRCCS Azienda Ospedaliero—Universitaria di Bologna, 40138 Bologna, ItalyDivision of Urology, IRCCS Azienda Ospedaliero—Universitaria di Bologna, 40138 Bologna, ItalyDivision of Urology, IRCCS Azienda Ospedaliero—Universitaria di Bologna, 40138 Bologna, ItalyDivision of Urology, IRCCS Azienda Ospedaliero—Universitaria di Bologna, 40138 Bologna, ItalyDivision of Urology, IRCCS Azienda Ospedaliero—Universitaria di Bologna, 40138 Bologna, Italy<i>Background and Objectives</i>: The aim of this article is to present a single-surgeon, open retroperitoneal lymph node dissection (RPLND) series for testicular cancer in a high-volume center. <i>Materials and Methods</i>: We reviewed data from patients who underwent RPLND performed by an experienced surgeon at our institution between 2000 and 2019. We evaluated surgical and perioperative outcomes, complications, Recurrence-Free Survival (RFS), Overall Survival (OS), and Cancer-Specific Survival (CSS). <i>Results</i>: RPLND was performed in primary and secondary settings in 21 (32%) and 44 (68%) patients, respectively. Median operative time was 180 min. Median hospital stay was 6 days. Complications occurred in 23 (35%) patients, with 9 (14%) events reported as Clavien grade ≥ 3. Patients in the primary RPLND group were significantly younger, more likely to have NSGCT, had higher clinical N0 and M0, and had higher nerve-sparing RPLND (all <i>p</i> ≤ 0.04) compared to those in the secondary RPLND group. In the median follow-up of 120 (56–180) months, 10 (15%) patients experienced recurrence. Finally, 20-year OS, CSS, and RFS were 89%, 92%, and 85%, respectively, with no significant difference in survival rates between primary vs. secondary RPLND subgroups (<i>p</i> = 0.64, <i>p</i> = 0.7, and <i>p</i> = 0.31, respectively). <i>Conclusions</i>: Open RPLND performed by an experienced high-volume surgeon achieves excellent oncological and functional outcomes supporting the centralization of these complex procedures.https://www.mdpi.com/1648-9144/59/1/133retroperitoneal lymph node dissectionopen approachtesticular cancerprimary settingsecondary settingRPLND |
| spellingShingle | Angelo Mottaran Amelio Ercolino Lorenzo Bianchi Pietro Piazza Francesco Manes Sasan Amirhassankhani Marco Salvador Francesco Chessa Beniamino Corcioni Alessandro Bertaccini Riccardo Schiavina Eugenio Brunocilla Twenty Years’ Experience in Retroperitoneal Lymph Node Dissection for Testicular Cancer in a Tertiary Referral Center Medicina retroperitoneal lymph node dissection open approach testicular cancer primary setting secondary setting RPLND |
| title | Twenty Years’ Experience in Retroperitoneal Lymph Node Dissection for Testicular Cancer in a Tertiary Referral Center |
| title_full | Twenty Years’ Experience in Retroperitoneal Lymph Node Dissection for Testicular Cancer in a Tertiary Referral Center |
| title_fullStr | Twenty Years’ Experience in Retroperitoneal Lymph Node Dissection for Testicular Cancer in a Tertiary Referral Center |
| title_full_unstemmed | Twenty Years’ Experience in Retroperitoneal Lymph Node Dissection for Testicular Cancer in a Tertiary Referral Center |
| title_short | Twenty Years’ Experience in Retroperitoneal Lymph Node Dissection for Testicular Cancer in a Tertiary Referral Center |
| title_sort | twenty years experience in retroperitoneal lymph node dissection for testicular cancer in a tertiary referral center |
| topic | retroperitoneal lymph node dissection open approach testicular cancer primary setting secondary setting RPLND |
| url | https://www.mdpi.com/1648-9144/59/1/133 |
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