+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Recurrence pattern and proposed surveillance protocol following post-chemotherapy retroperitoneal lymph node dissection



Recurrence pattern and proposed surveillance protocol following post-chemotherapy retroperitoneal lymph node dissection



Journal of Urology 177(1): 131-138



We evaluated the recurrence pattern in patients with nonseminomatous germ cell tumors treated with post-chemotherapy retroperitoneal lymph node dissection and determined the optimal surveillance strategy in these patients. Between 1980 and 2003, 236 patients with clinical stage IIA-III nonseminomatous germ cell tumors underwent post-chemotherapy retroperitoneal lymph node dissection. Patients with increased preoperative tumor markers (alpha-fetoprotein greater than 15 ng/ml and/or beta-human chorionic gonadotropin greater than 2.2 U/ml) were excluded from study resulting in 198 patients for analysis. We retrospectively reviewed medical records for pertinent clinical and treatment related outcomes. In our patient population recurrence developed in 45 (23%) patients and 22 (11%) died of disease at a median followup of 41 months (range 6 to 250) after retroperitoneal lymph node dissection. The clinical stage of testis cancer was IIA in 17, IIB in 49, IIC in 83 and III in 49 patients. Of the 45 patients with postoperative recurrence, 16 had concomitant multiple sites of recurrence with a total of 64 sites reported. Of the cases of recurrence 21 (46.7%) were in those of clinical stage III, 18 (40%) stage IIC and 6 (11.8%) stage IIB disease. The most frequent site of recurrence was the chest (32, 49%), followed by the abdomen (14, 22%), supraclavicular lymph nodes (8, 13%), brain (5, 8%) and other sites (5, 8%). Based on the recurrence pattern we propose stage specific surveillance guidelines for the followup of patients after post-chemotherapy retroperitoneal lymph node dissection. These guidelines help identify patients at high risk for disease progression and, thus, requiring more stringent postoperative followup.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 013009331

Download citation: RISBibTeXText

PMID: 17162023

DOI: 10.1016/j.juro.2006.08.092


Related references

Recurrence pattern in patients with necrosis only at post chemotherapy retroperitoneal lymph node dissection (PCRPLND). The Journal of Urology 179(4): 270, 2008

Predicting recurrence following post-chemotherapy retroperitoneal lymph node dissection for residual fibrosis or teratoma. Journal of Clinical Oncology 24(18_Suppl): 4551-4551, 2016

Early results of chemotherapy with retroperitoneal lymph node dissection for isolated retroperitoneal recurrence of upper urinary tract urothelial carcinoma after nephroureterectomy. Canadian Journal of Urology 17(3): 5184-5189, 2010

The impact of bleomycin on retroperitoneal histology at post-chemotherapy retroperitoneal lymph node dissection of good risk germ cell tumors. Journal of Urology 193(2): 507-512, 2015

Post chemotherapy laparoscopic retroperitoneal lymph node dissection. Archivos Espanoles de Urologia 59(5): 517-523, 2006

Complications of post-chemotherapy retroperitoneal lymph node dissection. Journal of Urology 169(4 Suppl.): 240, 2003

Aortic replacement during post-chemotherapy retroperitoneal lymph node dissection. Journal of Urology 165(5): 1517-1520, 2001

Post-Chemotherapy Robotic Retroperitoneal Lymph Node Dissection: Institutional Experience. Journal of Endourology 30(5): 510-519, 2016

Minimally invasive post-chemotherapy retroperitoneal lymph node dissection for nonseminoma. Canadian Journal of Urology 22(4): 7882-7889, 2015

Outcomes of post-chemotherapy retroperitoneal lymph node dissection associated-anejaculation management. Journal of Urology 179(4): 657, 2008

Complications of post-chemotherapy retroperitoneal lymph node dissection for testis cancer. Journal of Urology 171(5): 1839-1841, 2004

Outcomes of the management of post-chemotherapy retroperitoneal lymph node dissection-associated anejaculation. Bju International 110(8): 1196-1200, 2012

Hyperamylasemia after post-chemotherapy retroperitoneal lymph node dissection for testis cancer. Journal Of Urology. 154(4): 1373-1375, 1995

Is retroperitoneal histology predictive of liver histology at concurrent post-chemotherapy retroperitoneal lymph node dissection and hepatic resection?. Journal of Urology 184(3): 949-953, 2010

Complications of retroperitoneal lymph node dissection in testicular cancer: Primary and post-chemotherapy. Seminars in Surgical Oncology 17(4): 263-267, 1999