The present study is performed to determine whether retroperitoneal lymphadenectomy (rPLa) perioperative mortality (PM) rates reported from center of excellence [Indiana University: 0% for primary and 0.8% for postchemotherapy (PC) rPLa] are applicable to institution at large. Between 1975 and, 327 assessable patients with nonseminomatous testicular tumors (NsTT) were treated with rPLa: primary in 134 (41%) and PC-rPLa in 193 (59%) patients. The observed PM rates were stratified according to age, clinical stage (Cs) and type of rPLa. The median age at rPLa was 28 years (range 16-54) : < 29 years in 194 (56.3%), 30-39 years in 90 (30.3%) and > 40 years in 44 (13.4%) patients. Of 327 rPLa patients, 81 (27.8%) were performed for localized (Cs-I), 179 (54.7%) for regional (Cs-II) and 57 (17.5%) for metastatic (Cs-III) disease. Ten (3.1%) patients died during initial 90 days after rPLa: 1 patient from pulmonary embolism, 2 of chemotherapyrelated toxicity and 7 of progressive disease due to preoperative worse prognostic factors. Of the entire cohort 30, 60 and 90-day PM rate was 0.3%, 1.0% and 1.3%, respectively. PM rate increase with increasing age: < 39 years 0%, 30-39 years 5.0% and > 40 years 9.3% (x2 trend test, P= 0.002). PM rate also increased with Cs: 0% localized, 2.8% for regional and 8.8% for metastatic disease (x2 trend test, p<0.001). PM rate at primary and PC-rPLa was increased with Cs: 0% localized, 2.8% for regional and 8.8% for metastatic disease (x2 trend test, p<0.001). PM rate at primary and PC-rPLa was 0.7% and 3.1% 9P<0.001). rPLa was associated with virtually no or low (2.8%) PM rate in patients with localized and regional disease, respectively. In contrast, the PM rate of 8.8% for patients with distant metastases and group > 40 years of age (9.3%) implies that rPLa for these patients
ApstraktCilj ove studije je da se odredi koliko perioperativni mortalitet (PM) posle retroperitonealne limfadenektomije (rPLa) iznet od strane iskusnih centara (Indiana University: 0% kod primarne i 0.8% kod posthemioterapijske (PH) rPLa) se može primeniti kod institucija u širem smislu. U periodu od 1975. do 2005., 327 pacijenata sa neseminomskim tumorima testisa (NsTT) je lečeno pomoću rPLa: primarna kod 134 (41%) i PH-rPLa kod 193 (59%) pacijenata. Učestalost PM je analizirana u zavisnosti od godina starosti, kliničkog stadijuma (Ks) i tipa rPLa. srednje životno doba pri rPLa je bilo 28 godina (raspon 16-54): < 29 godina kod 194 (56.3%), 30-39 godina kod 90 (30.9%) i > 40 godina kod 44 (13.4%) pacijenata. Od 327 učinjenih rPLa. 81 (27.8%) su učinjene kod pacijenata u Ks-I, 179 (54.7%) u Ks-II i 57 (17.5%) u Ks-III bolesti. deset (8.1%) pacijenata je umrlo tokom inicijalnih 90 dana posle rPLa: 1 pacijent od embolije pluća, 2 od toksiciteta hemioterapije i 7 od progresije bolesti zbog prisustva loših perioperativnih faktora rizika. Učestalost PM na 30, 60 i 90 dana u celoj grupi pacijenata je iznosila 0.3%, 1.0% i 1.3%, respektivno. PM je imao tendenciju rasta sa porastom godina starosti: < 29 godina 0%,...