Laparoscopic and open postchemotherapy retroperitoneal lymph node dissection in patients with advanced testicular cancer – a single center analysis

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–Whitney 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