Surgery of Testicular Tumors

Sheinfeld, Joel; Bosl, George J.

doi:10.1016/b978-1-4160-6911-9.00032-3

Cited by 14 publications

(27 citation statements)

References 232 publications

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“…All patients who underwent RPLND were treated with full bilateral template RPLND as previously described in detail. 9 Time to RPLND was calculated as the time between orchiectomy and RPLND. Time to relapse was calculated as the time between RPLND and the date of post-RPLND relapse.…”

Section: Methodsmentioning

confidence: 99%

Clinical Outcomes of Local and Metastatic Testicular Sex Cord-Stromal Tumors

et al. 2014

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Section: Methodsmentioning

confidence: 99%

Clinical Outcomes of Local and Metastatic Testicular Sex Cord-Stromal Tumors

et al. 2014

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“…Although the modified template is widely practiced, it is controversial in a postchemotherapy setting and a full bilateral resection is considered to be the standard procedure. [ 19 20 21 ] In another study, 7%–32% extratemplate retroperitoneal disease was reported, depending on the boundaries of the modified template used. [ 21 ] Beck et al .…”

Section: Discussionmentioning

confidence: 99%

Robot-assisted retroperitoneal lymph node dissection: Feasibility and outcome in postchemotherapy residual mass in testicular cancer

et al. 2017

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Introduction:We aimed to evaluate the surgical feasibility, complication, and oncological outcome of robot-assisted retroperitoneal lymph node dissection (RA-RPLND) in patients of testicular tumor with postchemotherapy residual retroperitoneal mass.Methods:A total of 13 patients underwent RA-RPLND between January 2012 and September 2016 at our institute. A study was started on December 2015, so data were collected retrospectively and prospectively regarding patient demography, tumor characteristics, surgical, pathological outcome, and oncological outcome.Results:RA-RPLND was successfully completed in all the 13 patients. Lateral approach was used in initial 12 patients with unilateral dissection in 11 patients and bilateral dissection after in 1 patient after repositioning in bilateral position. Supine robotic approach used in 1 patient. Median operative time was 200 min, median estimated blood loss was 120 ml, and median length of hospital stay was 4 days. The median yield of lymph node was 20. Three patients had positive lymph nodes, all had teratoma germ cell tumor. Ten patients had only necrosis in lymph nodes. After median follow-up 23 months (range 3-58 months), no systemic or retroperitoneal recurrence was found. Four patients developed chyle leak. One patient was managed conservatively with diet modification, one with intranodal lipiodol lymphangiography and two patients were managed surgically.Conclusion:RA-RPLND is safe and feasible for postchemotherapy residual mass with accepted compilation rate, but larger studies are required to establish its diagnostic and therapeutic utility along with safety of the procedure.

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“…[9] A study by Loehrer et al . reported late recurrence in 19% of patients with teratoma identified at the time of initial RPLND.…”

Section: Clinical Implications Of An Uncontrolled Retroperitoneummentioning

confidence: 99%

“…This is felt to be the result of embryologic migration of the testis through the retroperitoneum where it acquires drainage from the lymphatics adjacent to the aorta and inferior vena cava. [ 9 ] It is uncommon to observe metastases to the lung and posterior mediastinum without concomitant retroperitoneal disease. [ 9 10 ] Choriocarcinoma does show a higher rate of hematogenous spread, resulting in distant metastases without apparent retroperitoneal involvement, but still tends to follow a similar pattern to the other subtypes the majority of the time.…”

Section: Retroperitoneal Metastases In Testicular Gctsmentioning

confidence: 99%

“…[ 9 ] It is uncommon to observe metastases to the lung and posterior mediastinum without concomitant retroperitoneal disease. [ 9 10 ] Choriocarcinoma does show a higher rate of hematogenous spread, resulting in distant metastases without apparent retroperitoneal involvement, but still tends to follow a similar pattern to the other subtypes the majority of the time. [ 10 ]…”

Section: Retroperitoneal Metastases In Testicular Gctsmentioning

confidence: 99%

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Surgery for retroperitoneal relapse in the setting of a prior retroperitoneal lymph node dissection for germ cell tumor

et al. 2010

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Recognition of the therapeutic role of retroperitoneal lymph node dissection (RPLND) in the setting of testicular germ cell tumors (GCTs) is of utmost importance. Although the histologic findings of RPLND provide diagnostic and prognostic information, the adequacy of initial RPLND is an independent predictor of clinical outcome. Despite the advent of effective cisplatin-based chemotherapy for testicular GCTs, patients who have undergone suboptimal surgery at the time of initial RPLND are compromised. Despite the initial enthusiasm surrounding anatomic mapping studies, the use of modified RPLND templates has the potential to leave a significant number of patients with unresected retroperitoneal disease. Teratomatous elements are particularly common. Patients with retroperitoneal relapse following initial RPLND should be treated with reoperative RPLND and chemotherapy and can expect long term survival rates nearing 70% when treated in tertiary centers by experienced surgeons.

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Surgery of Testicular Tumors

Cited by 14 publications

References 232 publications

Clinical Outcomes of Local and Metastatic Testicular Sex Cord-Stromal Tumors

Clinical Outcomes of Local and Metastatic Testicular Sex Cord-Stromal Tumors

Robot-assisted retroperitoneal lymph node dissection: Feasibility and outcome in postchemotherapy residual mass in testicular cancer

Surgery for retroperitoneal relapse in the setting of a prior retroperitoneal lymph node dissection for germ cell tumor

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