Post-chemotherapy laparoscopic retroperitoneal lymph node dissection is feasible for stage IIA/B non-seminoma germ cell tumors

Terukazu Nakamura, Akihiro Kawauchi, Masakatsu Oishi, Takashi Ueda, Takumi Shiraishi, Hiroyuki Nakanishi, Kazumi Kamoi, Yoshio Naya, Fumiya Hongo, Koji Okihara, Tsuneharu Miki

Research output: Contribution to journalArticle

Abstract

Objective: To assess the efficacy, outcome and complications of post-chemotherapy laparoscopic retroperitoneal lymph node dissection (L-RPLND) for stage IIA/B testicular germ cell tumor (GCT) patients in comparison with open RPLND (O-RPLND). Methods: L-RPLND was performed in 14 patients with stage IIA/B non-seminoma GCTs among 154 non-seminoma patients who received RPLND after completion of chemotherapy with tumor marker normalization at our institution between 1998 and 2013. Their outcomes were compared with those of 14 patients with stage IIA/B non-seminoma GCTs treated with O-RPLND during the same period. Clinical parameters were compared between L-RPLND and O-RPLND. Results: There were no significant differences in the background characteristics of the two groups except for follow-up duration (36 months for L-RPLND, 70 months for O-RPLND; p = 0.02). Blood loss during surgery was significantly less for the L-RPLND group than for the O-RPLND group (155 mL for L-RPLND, 700 mL for O-RPLND; p < 0.001). Parameters related to post-operative recovery were significantly better for the L-RPLND group than for the O-RPLND group. Histopathological examination showed no difference between the two groups. Neither group had disease recurrence. Conclusion: Post-chemotherapy L-RPLND with a bilateral template and nerve-sparing method was safe, effective, and showed a high preservation rate of antegrade ejaculation with no deterioration of outcomes compared to O-RPLND.

Original languageEnglish (US)
Pages (from-to)791-795
Number of pages5
JournalInternational Journal of Clinical Oncology
Volume21
Issue number4
DOIs
StatePublished - Aug 1 2016

Keywords

  • Germ cell tumors
  • Laparoscopic retroperitoneal lymph node dissection
  • Non-seminoma
  • Post-chemotherapy
  • Stage IIA/B

ASJC Scopus subject areas

  • Surgery
  • Hematology
  • Oncology

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    Nakamura, T., Kawauchi, A., Oishi, M., Ueda, T., Shiraishi, T., Nakanishi, H., Kamoi, K., Naya, Y., Hongo, F., Okihara, K., & Miki, T. (2016). Post-chemotherapy laparoscopic retroperitoneal lymph node dissection is feasible for stage IIA/B non-seminoma germ cell tumors. International Journal of Clinical Oncology, 21(4), 791-795. https://doi.org/10.1007/s10147-015-0934-0