%0 Journal Article
%T Laparoscopic and open postchemotherapy retroperitoneal lymph node dissection in patients with advanced testicular cancer ¨C a single center analysis
%A Jonas Busch
%A Ahmed Magheli
%A Barbara Erber
%A Frank Friedersdorff
%A Ivan Hoffmann
%A Carsten Kempkensteffen
%A Steffen Weikert
%A Kurt Miller
%A Mark Schrader
%A Stefan Hinz
%J BMC Urology
%D 2012
%I BioMed Central
%R 10.1186/1471-2490-12-15
%X 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¨CWhitney U test respectively. Overall survival was evaluated with the log-rank test.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).L-PCLND represents a safe surgical option for well selected patients at an experienced center.PCLND plays an important role in the management of patients with advanced seminomatous and NSGCT [1-5]. The technical advances in radiographic staging and the increased use of tumor markers have improved the correct identification of candidates for PCLND [6]. However, even with the introduction of FDG-PET for staging of postchemotherapy seminoma patients we cannot reliably rule out viable disease in residual GCT [7]. Postchemotherapy residual masses in patients suffering from non-seminoma should be resect
%K Advanced testicular cancer
%K Postchemotherapy
%K Retroperitoneal lymph node dissection
%K Laparoscopy
%K Metastasis
%U http://www.biomedcentral.com/1471-2490/12/15