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Results for “Retroperitoneal lymph node dissection”

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At least 217 records · Page 12Linked to original sources
PubMed2001

Laparoscopic retroperitoneal lymph node dissection.

Laparoscopic RPLND for clinical stage I testicular tumors is superior to open surgery in terms of efficiency, morbidity, and costs and has equal diagnostic accuracy. A quality of life study has shown that patients prefer surgery to chemotherapy and laparoscopy to open surgery. Laparoscopic RPLND is also feasible after chemotherapy, and the results are as good as those achieved in clinical stage I disease. Patients with stage IIb lesions can be spared the third and fourth cycle of chemotherapy if diagnostic laparoscopic RPLND is performed to exclude active tumor or remove mature teratoma. Laparoscopic removal of residual tumors following conventional chemotherapy for stage IIb lesions can be performed with minimal morbidity. The long and steep learning curve remains the biggest obstacle in laparoscopic RPLND. Most centers specializing in the treatment of testicular cancer are not trained in laparoscopic surgery and vice versa; however, the growing importance of laparoscopy for oncologic indications should help to overcome this problem in the near future.

Adolescent↗
PubMed1996

Cisplatin-based chemotherapy after retroperitoneal lymph node dissection in patients with pathological stage II nonseminomatous germ cell tumors.

In order to assess the results of cisplatin-based chemotherapy after primary lymph node dissection in patients with pathological stage II nonseminomatous germ cell tumors of the testis, we retrospectively reviewed the long-term outcome of 44 patients who received adjuvant chemotherapy at Institut Gustave Roussy over a 7-year period. Two chemotherapy regimens were sequentially delivered. Twenty-three patients were treated with vinblastine, cyclophosphamide, bleomycin, actinomycin D, and cisplatin (mVAB-6, four cycles), while 21 patients received a combination of etoposide and cisplatin (EP, four cycles). After a median follow-up of 6 years, all patients remain free from progression. The long-term toxicity included retrograde ejaculation in eight patients and severe ototoxicity in two patients. We conclude that four cycles of cisplatin-based chemotherapy for pathological stage II testicular cancer resulted in a 100% cure rate with minimal toxicity.

Adolescent↗
PubMed1994

Fertility considerations in nerve-sparing retroperitoneal lymph-node dissection.

Nerve-sparing retroperitoneal lymph-node dissection (RPLND) maintains the patient's ability to ejaculate postoperatively. However, since testicular cancer patients sometimes have diminished spermatogenesis, questions have been raised as to the advisability of nerve preservation relative to ultimate fertility. Fertility status was assessed in clinical stage A patients by two methods. These included standard semen analysis and a post-RPLND survey. The results show that approximately 75% of non-seminomatous testicular cancer patients who present in clinical stage A have fertility potential as based on semen analysis. Additionally, of those patients responding to the post-RPLND survey who had attempted pregnancy following RPLND, 76% reported attainment of pregnancy. Nerve-sparing RPLND maintains fertility potential in clinical stage I patients; furthermore, this fertility potential appears to be worth preserving as many patients will be capable of impregnating their partners.

Ejaculation↗
PubMed1999

[Therapeutic results of second-look laporatomy with extensive dissection of retroperitoneal lymph nodes in ovarian cancer patients].

OBJECTIVE: To evaluate retrospectively the results of extensive lymphadenectomy during second-look laparotomy in patients with ovarian cancer. METHODS: An total of 63 patients with ovarian malignancies received second-look laparotomy (SLL). Retroperitoneal lymph nodes, including para-aortic nodes below the level of left renal vein and pelvic nodes were extensively dissected. RESULTS: Of the 63 patients, residual tumor was found in 24 (38.1%) on SLL. The frequency of residual tumor was positively correlated with the clinical stage and with the amount of tumor left after initial debulking but not with the degree of differentiation of tumor cells. Lymph node metastasis was pathologically confirmed in 19 cases (30.2%), in which no residual tumor was found in 8 patients. Tumor recurred in only 4 of the 39 patients (10.3%) with negative SLL. The overall 3- and 5-year survival rate was 75.4% and 68.3%, respectively. CONCLUSION: Extensive retroperitoneal lymph node dissection is recommended during SLL. It favors a decrease in recurrence rate in ovarian cancer patients negative on SLL.

Adolescent↗
PubMed1987

Management of patients with clinical stage I or II nonseminomatous germ cell tumors of the testis. Evolving therapeutic options.

Eighty patients with clinical stage I or II nonseminomatous germ cell tumors of the testis were managed with modified protocols, including modified nerve-sparing retroperitoneal lymph node dissection for patients with stage I cancer, retroperitoneal lymph node dissection for patients with low-volume stage II cancer, and initial chemotherapy with or without subsequent retroperitoneal lymphadenectomy for patients with high-volume stage II cancer. Patients with low-stage disease (clinical stage I) were treated successfully with modified retroperitoneal lymph node dissection (relapse rate, three of 40 patients). Clinical understaging was evidenced in 14 of 48 patients with clinical stage I disease who were found to have pathologic involvement of the retroperitoneal lymph nodes, including six patients with extensive retroperitoneal nodal involvement (pathologic stage B2). Of nine patients with retroperitoneal tumors less than 3 cm in diameter, four patients were satisfactorily treated with retroperitoneal lymph node dissection alone while five patients required chemotherapy after retroperitoneal lymph node dissection. Of 26 patients with retroperitoneal tumors 3 to 5 cm in diameter, 17 patients were treated with chemotherapy alone. All patients remain free of disease after the completion of definitive therapy. We conclude that therapeutic options should be modified based on histologic factors in the primary tumor, extent of retroperitoneal disease as indicated on a computed tomographic scan, and presence or absence of elevated tumor markers. By consideration these factors, optimum therapy can be selected to achieve the highest long-term survival rate with the least morbidity.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2006

Laparoscopic and open retroperitoneal lymph-node dissection for clinical stage I nonseminomatous germ-cell testis tumors.

BACKGROUND AND PURPOSE: Laparoscopic retroperitoneal lymph node dissection (L-RPLND) has been reported as efficacious for staging of the retroperitoneum in patients with stage I nonseminomatous germ-cell testis tumors (NSGCT). However, reports are limited to a few centers, and this procedure has yet to be widely accepted as an alternative to open retroperitoneal lymph node dissection (O-RPLND). Thus, we compared our contemporary open and laparoscopic experience with RPLND. PATIENTS AND METHODS: A retrospective chart review identified 28 patients who underwent either open (N = 6) or laparoscopic (N = 22) RPLND for clinical stage I NSGCT since 2000. Each patient received the appropriate modified template dissection. Perioperative demographic data, histologic nodal status, and recurrence data were evaluated. The mean follow-up was similar in the two groups. RESULTS: The mean operative time was not significantly different (313 minutes for L-RPLND v 284 minutes for O-RPLND). However, L-RPLND did have a significantly shorter hospitalization (1.2 v 8.5 days). Significantly more lymph nodes were removed with O-LPLND than with L-RPLND (mean 33 v 17). There was a single recurrence outside the modified template after both L-RPLND and O-RPLND and one within-the-template recurrence in the O-RPLND group. CONCLUSIONS: The L-RPLND is associated with less blood loss and a shorter hospital stay than O-RPLND, whereas the lymph-node yield of O-RPLND is greater. However, during the critical early follow-up period, the oncologic effectiveness and morbidity of L-RPLND for clinical stage I NSGCT appears similar to that of O-RPLND.

Adolescent↗