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https://www.readbyqxmd.com/read/28325537/midline-extraperitoneal-approach-to-retroperitoneal-lymph-node-dissection-in-testicular-cancer-minimizing-surgical-morbidity
#1
Sumeet Syan-Bhanvadia, Soroush T Bazargani, Thomas G Clifford, Jie Cai, Gus Miranda, Siamak Daneshmand
BACKGROUND: Retroperitoneal lymph node dissection (RPLND) is an important component of the management of testicular germ cell tumor (GCT) but carries significant surgical morbidity. OBJECTIVE: To describe our experience with a midline extraperitoneal (EP) approach to RPLND for seminomatous and nonseminomatous GCT. DESIGN, SETTING, AND PARTICIPANTS: From 2010 to 2015, 122 consecutive patients underwent RPLND from a prospective database. Patients requiring aortic resection or retrocrural dissection or with intraperitoneal disease were excluded...
March 18, 2017: European Urology
https://www.readbyqxmd.com/read/28296054/modified-retroperitoneal-lymph-node-dissection-for-postchemotherapy-residual-tumor-a-long-term-update
#2
Jane S Cho, Hristos Z Kaimakliotis, K Clint Cary, Timothy A Masterson, Stephen Beck, Richard Foster
OBJECTIVES: To update previously reported outcomes of modified template postchemotherapy retroperitoneal lymph node dissection (PC-RPLND) in appropriately selected patients with metastatic non-seminomatous germ cell tumor (NSGCT). Our previous report was criticized for short follow-up. Herein, we provide a long-term update on this cohort. MATERIALS AND METHODS: One hundred patients with normal serum markers after cisplatin-based chemotherapy and residual retroperitoneal tumor underwent modified PC-RPLND between 1991 and 2004...
March 13, 2017: BJU International
https://www.readbyqxmd.com/read/28262537/robot-assisted-retroperitoneal-lymph-node-dissection-ra-rplnd-in-the-adolescent-population
#3
A P Glaser, D K Bowen, B W Lindgren, J J Meeks
BACKGROUND: Robot-assisted retroperitoneal lymph node dissection (RA-RPLND) has built on success and techniques of laparoscopic RPLND, with the added benefits of robotic technology. This paper demonstrates use of the da Vinci Xi(®) system for RA-RPLND in two adolescent patients. METHODS: Case #1: A 17-year-old male presented with a left testicular mass and elevated alpha-fetoprotein (AFP) and human chorionic gonadotropin (HCG). Pathology revealed a mixed non-seminomatous germ cell tumor (60% embryonal, 35% yolk sac, 5% choriocarcinoma, + lymphovascular invasion)...
February 17, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28150168/retroperitoneal-lymph-node-dissection-an-update-in-testicular-malignancies
#4
REVIEW
K Yadav
Management of testicular cancer has evolved through many breakthroughs. The decades of zeal to improve oncologic adequacy and to decrease morbidity has led to the current scientific knowledge of retroperitoneal lymph node dissection templates. Retroperitoneal lymph node dissection (RPLND) has potential for staging, prognostication and therapeutic importance in the management of testicular malignancy. RPLND has overcome limitations of current imaging which understage 30% of stage I disease and overstage 25-30% of stage II disease...
February 1, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/28124545/robot-assisted-laparoscopic-retroperitoneal-lymph-node-dissection-in-testicular-tumor
#5
Fabio C M Torricelli, Denis Jardim, Giuliano B Guglielmetti, Vipul Patel, Rafael F Coelho
INTRODUCTION AND OBJECTIVE: Retroperitoneal lymph node dissection (RPLND) is indicated for patients with non-seminomatous germ cell tumor (NSGCT) with residual disease after chemotherapy. Although the gold standard approach is still the open surgery, few cases of robot-assisted laparoscopic RPLND have been described. Herein, we aim to present the surgical technique for robot-assisted laparoscopic RPLND. PATIENT AND METHOD: A 30 year-old asymptomatic man presented with left testicular swelling for 2 months...
January 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/27981731/robotic-salvage-retroperitoneal-and-pelvic-lymph-node-dissection-for-node-only-recurrent-prostate-cancer-technique-and-initial-series
#6
Andre Abreu, Carlos Fay, Daniel Park, David Quinn, Tanya Dorff, John Carpten, Peter Kuhn, Parkash Gill, Fabio Almeida, Inderbir Gill
OBJECTIVES: To describe the technique of robot-assisted high-extended salvage retroperitoneal and pelvic lymphadenectomy (sRPLND+PLND) for 'node-only' recurrent prostate cancer. PATIENTS AND METHODS: In all, 10 patients underwent robot-assisted sRPLND+PLND (09/2015-03/2016) for 'node-only' recurrent prostate cancer, as identified by (11) C-acetate positron emission tomography/computed tomography imaging. Our anatomical template extends from bilateral renal artery/vein cranially up to Cloquet's node caudally, completely excising lymphatic-fatty tissue from aorto-caval and iliac vascular trees; RPLND precedes PLND...
December 15, 2016: BJU International
https://www.readbyqxmd.com/read/27909618/clinico-pathological-outcomes-of-post-primary-and-salvage-chemotherapy-retroperitoneal-lymph-node-dissection-for-mixed-germ-cell-tumors-king-hussein-cancer-center-experience
#7
Kholoud Alqasem, Ibrahim Abukhiran, Judy Jasser, Tamer Bisharat, Riyad T Ellati, Jakub Khzouz, Ibrahim Al-Saidi, Ali Al-Daghamin
OBJECTIVE: We sought to characterize clinical and pathologic outcomes of advanced mixed germ cell tumors after retroperitoneal lymph node dissection for post-chemotherapy residual masses. MATERIAL AND METHODS: Between January 2006 and November 2015, 56 patients underwent retroperitoneal lymph node dissection (RPLND) for residual masses of greater than 1 cm after receiving either primary chemotherapy or salvage chemotherapy. Retrospective review of the patients' characteristics, clinical, pathological, and treatment outcomes were performed after institutional review board (IRB) and ethics committee approval...
December 2016: Turkish Journal of Urology
https://www.readbyqxmd.com/read/27879966/andrological-complications-following-retroperitoneal-lymphnode-dissection-for-testicular-cancer-a-narrative-review
#8
Alessandro Crestani, Francesco Esperto, Marta Rossanese, Gianluca Giannarini, Nicola Nicolai, Vincenzo Ficarra
Retroperitoneal lymphnode dissection (RPLND) is a fundamental surgical step in the treatment of testicular cancer. Nowadays primary RPLND has partially lost its role in favour of active surveillance (for low risk stage I disease) and short cycle chemotherapy in non-seminomatous germ cell tumour (NSGCT). Conversely, postchemotherapy-RPLND (PC-RPLND) remains the standard treatment for residual masses after chemotherapy. In consideration of curability rate of testicular cancer and the life expectancy of testicular cancer survivors the identification and the prevention of andrological complications became fundamental...
November 23, 2016: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
https://www.readbyqxmd.com/read/27878048/validation-of-a-prediction-model-for-avoiding-post-chemotherapy-retroperitoneal-lymphadenectomy-in-patients-with-metastatic-nonseminomatous-germ-cell-cancer
#9
Nahid Punjani, Nicholas Power, James J Vanhie, Eric Winquist
INTRODUCTION: Post-chemotherapy residual masses (PCRMs) may contain persistent cancer or teratoma in more than 50% of patients with metastatic non-seminomatous germ cell tumours (mNSGCTs). Retroperitoneal lymph node dissection (RPLND) is curative, but controversy exists about selection criteria for surgery. A validated prediction model by Vergouwe et al (2007) based on over 1000 patients was evaluated at our centre. METHODS: mNSGCT patients treated with RPLND for PCRMs were identified from an electronic database...
August 2016: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/27859263/post-chemotherapy-retroperitoneal-teratoma-in-nonseminomatous-germ-cell-tumors-do-predictive-factors-exist-results-from-a-national-multicenter-study
#10
MULTICENTER STUDY
Marie Dusaud, Bernard Malavaud, Younes Bayoud, Philippe Sebe, Jean Luc Hoepffner, Laurent Salomon, Alain Houlgatte, Géraldine Pignot, Jérome Rigaud, Aude Fléchon, Christian Pfister, Morgan Rouprêt, Michel Soulié, Arnaud Méjean, Xavier Durand
BACKGROUND AND OBJECTIVES: To identify predictive preoperative factors of the presence of teratoma in retroperitoneal lymph node dissection specimens. METHODS: We performed a 20 years multicenter retrospective analysis of all patients who underwent retroperitoneal lymph node dissection for residual masses after chemotherapy (PC-RPLND). Patients had undergone PC-RPLND after chemotherapy for advanced testicular cancer. The histologic components of the primary tumor were compared with those of the residual masses using logistic regression...
December 2016: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27831507/surgical-management-of-complex-residual-masses-following-systemic-chemotherapy-for-metastatic-testicular-germ-cell-tumours
#11
A Heidenreich, F Haidl, P Paffenholz, Ch Pape, U Neumann, D Pfister
BACKGROUND: Post-chemotherapy retroperitoneal lymphadenectomy (PC-RPLND) represents the treatment of choice in patients with residual masses following chemotherapy for metastatic germ cell tumours. Involvement of major retroperitoneal vessels or thoracic/lumbar spine is rare and challenging but needs complete resection for curative intent. We report on our experience in the management of such complex cases. PATIENTS AND METHODS: A total of 185 patients underwent PC-RPLND and we identified 25 (13...
November 9, 2016: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/27812752/outcomes-of-surveillance-versus-adjuvant-chemotherapy-for-patients-with-stage-ia-and-ib-nonseminomatous-testicular-germ-cell-tumors
#12
Mahmut Gumus, Ahmet Bilici, Hatice Odabas, Bala Basak Oven Ustaalioglu, Nurten Kandemir, Umut Demirci, Sener Cihan, Ibrahim Vedat Bayoglu, Turkan Ozturk, Esma Turkmen, Zurat Urakci, Mehmet Metin Seker, Yusuf Gunaydin, Fatih Selcukbiricik, Nedim Turan, Alper Sevinc
BACKGROUND: Currently, it is accepted that risk assessment of clinical stage I (CS I) nonseminomatous germ cell tumors (NSGCT) patient is mainly dependent on the presence of lymphovascular invasion (LVI). Initial active surveillance, adjuvant chemotherapy and retroperitoneal lymph node dissection (RPLND) are acceptable treatment options for these patients, but there is no uniform consensus. The purpose of this study was to compare outcomes of active surveillance with adjuvant chemotherapy...
November 3, 2016: World Journal of Urology
https://www.readbyqxmd.com/read/27778488/robot-assisted-laparoscopic-retroperitoneal-lymph-node-dissection-in-testicular-tumor
#13
Fabio C M Torricelli, Denis Jardim, Giuliano B Guglielmetti, Vipul Patel, Rafael F Coelho
INTRODUCTION AND OBJECTIVE: Retroperitoneal lymph node dissection (RPLND) is indicated for patients with non-seminomatous germ cell tumor (NSGCT) with residual disease after chemotherapy. Although the gold standard approach is still the open surgery, few cases of robot-assisted laparoscopic RPLND have been described. Herein, we aim to present the surgical technique for robot-assisted laparoscopic RPLND. PATIENT AND METHOD: A 30 year-old asymptomatic man presented with left testicular swelling for 2 months...
January 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/27720783/clinical-outcome-of-patients-with-fibrosis-necrosis-at-post-chemotherapy-retroperitoneal-lymph-node-dissection-for-advanced-germ-cell-tumors
#14
Roy Mano, Maria F Becerra, Brett S Carver, George J Bosl, Robert J Motzer, Dean F Bajorin, Darren R Feldman, Joel Sheinfeld
PURPOSE: Fibrosis accounts for approximately 50% of histological findings at post-chemotherapy retroperitoneal lymph node dissection, and is associated with reported relapse rates of 10% to 15%. We characterized patients with fibrosis at post-chemotherapy retroperitoneal lymph node dissection and identified predictors of adverse outcomes in this group. MATERIALS AND METHODS: We reviewed the medical records of men who underwent post-chemotherapy retroperitoneal lymph node dissection between 1989 and 2013 with histological findings of necrosis/fibrosis...
February 2017: Journal of Urology
https://www.readbyqxmd.com/read/27658663/management-of-duodenal-involvement-during-retroperitoneal-lymph-node-dissection-for-germ-cell-tumors
#15
Joseph M Jacob, Clint Cary, Song Jiang, Richard S Foster, Michael G House
OBJECTIVE: To describe patient characteristics and outcomes after duodenal repair during postchemotherapy retroperitoneal lymph node dissection (PC-RPLND) and to identify treatment and management patterns. METHODS: The Indiana University Testis Cancer database was used to identify all patients who underwent simultaneous partial duodenectomy and PC-RPLND from 1983 to 2013. Patient records were reviewed to describe patient and tumor characteristics, type of duodenal restoration, postoperative management, and complications...
January 2017: Urology
https://www.readbyqxmd.com/read/27626903/management-trends-for-men-with-early-stage-nonseminomatous-germ-cell-tumors-of-the-testicle-an-analysis-of-the-national-cancer-database
#16
Adam B Weiner, Shane M Pearce, Scott E Eggener
BACKGROUND: Surveillance has been recommended more frequently as a postorchiectomy management option for men with early stage nonseminomatous germ cell tumor (NSGCT) of the testicle. It is unknown how contemporary treatment patterns reflect these recommendations. METHODS: Data from the National Cancer Database were extracted on all men who were diagnosed with clinical stage (CS) IA or CSIB NSGCT between 2004 and 2013. Temporal trends in the use of chemotherapy, retroperitoneal lymph node dissection (RPLND), and surveillance were measured; and multivariable logistic regression was used to analyze the association of patient and clinical covariates with use of surveillance...
September 14, 2016: Cancer
https://www.readbyqxmd.com/read/27618772/management-of-stage-i-testicular-germ-cell-tumours
#17
REVIEW
Michal Chovanec, Nasser Hanna, K Clint Cary, Lawrence Einhorn, Costantine Albany
Clinical stage I testicular germ cell tumours (TGCT) are highly curable neoplasms. The treatment of stage I testicular cancer is complex and requires a multidisciplinary approach. Standard options after radical orchiectomy for seminoma include active surveillance, radiation therapy or 1-2 cycles of carboplatin, and options for nonseminoma include active surveillance, retroperitoneal lymph node dissection (RPLND) or 1-2 cycles of bleomycin plus etoposide plus cisplatin (BEP). All the options should be discussed with each patient and treatment choices should be made by shared decision making as virtually all patients with clinical stage I TGCT can be cured of their disease...
November 2016: Nature Reviews. Urology
https://www.readbyqxmd.com/read/27533924/laparoscopic-postchemotherapy-retroperitoneal-lymph-node-dissection-can-be-a-standard-option-in-defined-nonseminomatous-germ-cell-tumor-patients
#18
Nicola Nicolai, Francesco Cattaneo, Davide Biasoni, Mario Catanzaro, Tullio Torelli, Michele Zazzara, Andrea Necchi, Patrizia Giannatempo, Daniele Raggi, Luigi Piva, Maurizio Colecchia, Roberto Salvioni, Silvia Stagni
BACKGROUND: Residual retroperitoneal masses in NSGCT need postchemotherapy retroperitoneal lymph-node dissection (PC-RPLND). Open (O) PC-RPLND is a standardized procedure, but morbidity is not negligible and mostly attributable to laparotomy. Laparoscopic (L) PC-RPLND may improve tolerability profile. We evaluated viability, toxicity, and short to medium-term oncologic outcome of L-PC-RPLND following well-defined selection criteria. PATIENTS AND METHODS: Since February 2011, consecutive patients with a unilateral residual mass (≥1 cm or growing), normalized markers, and limited encasement of inferior vena cava and/or aorta were candidate to unilateral L-PC-RPLND...
October 2016: Journal of Endourology
https://www.readbyqxmd.com/read/27460844/post-chemotherapy-robotic-bilateral-retroperitoneal-lymph-node-dissection-using-a-novel-single-dock-technique
#19
Thomas E Stout, Samit D Soni, Alvin C Goh
There have been no previous reports of post-chemotherapy robotic bilateral retroperitoneal lymph node dissection (RPLND) using a single-dock technique. One deterrent of robotic RPLND is that accessing bilateral retroperitoneal spaces requires patient reposition and surgical robot redocking, therefore increasing operative time. Herein we provide the first step-by-step description of a single-dock technique for robotic bilateral RPLND in the post-chemotherapy setting. We describe port placement and technique for robot positioning to optimize access to bilateral retroperitoneal spaces with a single dock...
December 2016: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/27409991/impact-of-urologist-density-and-county-rurality-on-the-practice-of-retroperitoneal-lymph-node-dissection-and-cancer-specific-death-in-patients-with-nonseminomatous-germ-cell-tumors
#20
Joseph Clemons, Whitney E Zahnd, Max Nutt, Dan Sadowski, Danuta Dynda, Shaheen Alanee
PURPOSE: To investigate the impact of rural status and urologist density on the practice of retroperitoneal lymph node dissection (RPLND) and cancer-specific death (CSD) in patients with nonseminomatous germ cell tumor (NSGCT). METHODS: Urologist density was determined from 2014 to 2015 Area Health Resource File data, and rural residence was determined using the 2003 Rural-Urban Continuum Codes. All cases of NSGCT within Surveillance, Epidemiology and End Results (SEER) 18 with known county code were used for analysis (n = 9473)...
March 2017: Journal of Adolescent and Young Adult Oncology
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