Laparoscopic and open postchemotherapy retroperitoneal lymph node dissection in patients with advanced testicular cancer – a single center analysis
<p>Abstract</p> <p>Background</p> <p>The open approach represents the gold standard for postchemotherapy retroperitoneal lymph node dissection (O-PCLND) in patients with residual testicular cancer. We analyzed laparoscopic postchemotherapy retroperitoneal lymph node dis...
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| Format: | Article |
| Language: | English |
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BMC
2012-05-01
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| Series: | BMC Urology |
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| Online Access: | http://www.biomedcentral.com/1471-2490/12/15 |
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| author | Busch Jonas Magheli Ahmed Erber Barbara Friedersdorff Frank Hoffmann Ivan Kempkensteffen Carsten Weikert Steffen Miller Kurt Schrader Mark Hinz Stefan |
| author_facet | Busch Jonas Magheli Ahmed Erber Barbara Friedersdorff Frank Hoffmann Ivan Kempkensteffen Carsten Weikert Steffen Miller Kurt Schrader Mark Hinz Stefan |
| author_sort | Busch Jonas |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>The open approach represents the gold standard for postchemotherapy retroperitoneal lymph node dissection (O-PCLND) in patients with residual testicular cancer. We analyzed laparoscopic postchemotherapy retroperitoneal lymph node dissection (L-PCLND) and O-PCLND at our institution.</p> <p>Methods</p> <p>Patients underwent either L-PCLND (n = 43) or O-PCLND (n = 24). Categorical and continuous variables were compared using the Fisher exact test and Mann–Whitney <it>U</it> test respectively. Overall survival was evaluated with the log-rank test.</p> <p>Results</p> <p>Primary histology was embryonal cell carcinomas (18 patients), pure seminoma (2 cases) and mixed NSGCTs (47 patients). According to the IGCCCG patients were categorized into “good”, “intermediate” and “poor prognosis” disease in 55.2%, 14.9% and 20.8%, respectively. Median operative time for L-PCLND was 212 min and 232 min for O-PCLND (p = 0.256). Median postoperative duration of drainage and hospital stay was shorter after L-PCLND (0.0 vs. 3.5 days; p < 0.001 and 6.0 vs. 11.5 days; p = 0.002). Intraoperative complications occurred in 21.7% (L-PCLND) and 38.0% (O-PCLND) of cases with 19.5% and 28.5% of Clavien Grade III complications for L-PCLND and O-PCLND, respectively (p = 0.224). Significant blood loss (>500 ml) was almost equally distributed (8.6% vs. 14.2%: p = 0.076). No significant differences were observed for injuries of major vessels and postoperative complications (p = 0.758; p = 0.370). Tumor recurrence occurred in 8.6% following L-PCLND and in 14.2% following O-PCLND with a mean disease-free survival of 76.6 and 89.2 months, respectively. Overall survival was 83.3 and 95.0 months for L-PCNLD and O-PCLND, respectively (p = 0.447).</p> <p>Conclusions</p> <p>L-PCLND represents a safe surgical option for well selected patients at an experienced center.</p> |
| first_indexed | 2024-04-14T03:55:03Z |
| format | Article |
| id | doaj.art-09df7ac7fee74889a5e6c02c2fc22565 |
| institution | Directory Open Access Journal |
| issn | 1471-2490 |
| language | English |
| last_indexed | 2024-04-14T03:55:03Z |
| publishDate | 2012-05-01 |
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| series | BMC Urology |
| spelling | doaj.art-09df7ac7fee74889a5e6c02c2fc225652022-12-22T02:13:51ZengBMCBMC Urology1471-24902012-05-011211510.1186/1471-2490-12-15Laparoscopic and open postchemotherapy retroperitoneal lymph node dissection in patients with advanced testicular cancer – a single center analysisBusch JonasMagheli AhmedErber BarbaraFriedersdorff FrankHoffmann IvanKempkensteffen CarstenWeikert SteffenMiller KurtSchrader MarkHinz Stefan<p>Abstract</p> <p>Background</p> <p>The open approach represents the gold standard for postchemotherapy retroperitoneal lymph node dissection (O-PCLND) in patients with residual testicular cancer. We analyzed laparoscopic postchemotherapy retroperitoneal lymph node dissection (L-PCLND) and O-PCLND at our institution.</p> <p>Methods</p> <p>Patients underwent either L-PCLND (n = 43) or O-PCLND (n = 24). Categorical and continuous variables were compared using the Fisher exact test and Mann–Whitney <it>U</it> test respectively. Overall survival was evaluated with the log-rank test.</p> <p>Results</p> <p>Primary histology was embryonal cell carcinomas (18 patients), pure seminoma (2 cases) and mixed NSGCTs (47 patients). According to the IGCCCG patients were categorized into “good”, “intermediate” and “poor prognosis” disease in 55.2%, 14.9% and 20.8%, respectively. Median operative time for L-PCLND was 212 min and 232 min for O-PCLND (p = 0.256). Median postoperative duration of drainage and hospital stay was shorter after L-PCLND (0.0 vs. 3.5 days; p < 0.001 and 6.0 vs. 11.5 days; p = 0.002). Intraoperative complications occurred in 21.7% (L-PCLND) and 38.0% (O-PCLND) of cases with 19.5% and 28.5% of Clavien Grade III complications for L-PCLND and O-PCLND, respectively (p = 0.224). Significant blood loss (>500 ml) was almost equally distributed (8.6% vs. 14.2%: p = 0.076). No significant differences were observed for injuries of major vessels and postoperative complications (p = 0.758; p = 0.370). Tumor recurrence occurred in 8.6% following L-PCLND and in 14.2% following O-PCLND with a mean disease-free survival of 76.6 and 89.2 months, respectively. Overall survival was 83.3 and 95.0 months for L-PCNLD and O-PCLND, respectively (p = 0.447).</p> <p>Conclusions</p> <p>L-PCLND represents a safe surgical option for well selected patients at an experienced center.</p>http://www.biomedcentral.com/1471-2490/12/15Advanced testicular cancerPostchemotherapyRetroperitoneal lymph node dissectionLaparoscopyMetastasis |
| spellingShingle | Busch Jonas Magheli Ahmed Erber Barbara Friedersdorff Frank Hoffmann Ivan Kempkensteffen Carsten Weikert Steffen Miller Kurt Schrader Mark Hinz Stefan Laparoscopic and open postchemotherapy retroperitoneal lymph node dissection in patients with advanced testicular cancer – a single center analysis BMC Urology Advanced testicular cancer Postchemotherapy Retroperitoneal lymph node dissection Laparoscopy Metastasis |
| title | Laparoscopic and open postchemotherapy retroperitoneal lymph node dissection in patients with advanced testicular cancer – a single center analysis |
| title_full | Laparoscopic and open postchemotherapy retroperitoneal lymph node dissection in patients with advanced testicular cancer – a single center analysis |
| title_fullStr | Laparoscopic and open postchemotherapy retroperitoneal lymph node dissection in patients with advanced testicular cancer – a single center analysis |
| title_full_unstemmed | Laparoscopic and open postchemotherapy retroperitoneal lymph node dissection in patients with advanced testicular cancer – a single center analysis |
| title_short | Laparoscopic and open postchemotherapy retroperitoneal lymph node dissection in patients with advanced testicular cancer – a single center analysis |
| title_sort | laparoscopic and open postchemotherapy retroperitoneal lymph node dissection in patients with advanced testicular cancer a single center analysis |
| topic | Advanced testicular cancer Postchemotherapy Retroperitoneal lymph node dissection Laparoscopy Metastasis |
| url | http://www.biomedcentral.com/1471-2490/12/15 |
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