Primary Retroperitoneal Lymph Node Dissection for Seminoma Metastatic to the Retroperitoneum

No AccessJournal of UrologyAdult Urology6 Sep 2023Primary Retroperitoneal Lymph Node Dissection for Seminoma Metastatic to the Retroperitoneum Richard S. Matulewicz, Nicole Benfante, Samuel A. Funt, Darren R. Feldman, Brett Carver, Alexander Doudt, Andrea Knezevic, and Joel Sheinfeld Richard S. MatulewiczRichard S. Matulewicz *Correspondence: 353 E. 68th Street, New York, NY 10065 (telephone: 646-422-4874; FAX: 646-888-6452; email: E-mail Address: [email protected]). https://orcid.org/0000-0003-0757-0885 Memorial Sloan Kettering Cancer Center, Department of Surgery, Urology Service More articles by this author , Nicole BenfanteNicole Benfante Memorial Sloan Kettering Cancer Center, Department of Surgery, Urology Service More articles by this author , Samuel A. FuntSamuel A. Funt Memorial Sloan Kettering Cancer Center, Department of Medicine, Genitourinary Oncology Service More articles by this author , Darren R. FeldmanDarren R. Feldman Memorial Sloan Kettering Cancer Center, Department of Medicine, Genitourinary Oncology Service More articles by this author , Brett CarverBrett Carver Memorial Sloan Kettering Cancer Center, Department of Surgery, Urology Service More articles by this author , Alexander DoudtAlexander Doudt Memorial Sloan Kettering Cancer Center, Department of Surgery, Urology Service More articles by this author , Andrea KnezevicAndrea Knezevic Memorial Sloan Kettering Cancer Center, Department of Epidemiology & Biostatistics More articles by this author , and Joel SheinfeldJoel Sheinfeld Memorial Sloan Kettering Cancer Center, Department of Surgery, Urology Service More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003697AboutPDF ToolsAdd to favoritesDownload CitationsTrack Citations ShareFacebookLinked InTwitterEmail Abstract Purpose: Primary surgical treatment with retroperitoneal lymph node dissection aims to accurately stage and treat patients with node-positive pure seminoma while avoiding long-term risks of chemotherapy or radiation, traditional standard-of-care treatments. Materials and Methods: We reported the pathologic and oncologic outcomes of patients with pure seminoma treated with primary retroperitoneal lymph node dissection in a retrospective, single-institution case series over 10 years. The primary outcome was two-year recurrence-free survival stratified by adjuvant management strategy (surveillance versus adjuvant chemotherapy). Results: Forty-five patients treated with primary retroperitoneal lymph node dissection for pure testicular seminoma metastatic to the retroperitoneum were identified. Median size of largest lymph node before surgery was 1.8 cm. Viable germ cell tumor, all of which was pure seminoma, was found in 96% (n=43) of patients. The median number of positive nodes and nodes removed was 2 and 54, respectively. Median positive pathologic node size was 2 cm (IQR 1.4–2.5 cm, range 0.1–5 cm). Four of 29 patients managed with post-operative surveillance experienced relapse; two-year recurrence-free survival was 81%. Median follow-up for those managed with surveillance who did not relapse was 18.5 months. There were no relapses in the retroperitoneum, visceral recurrences, or deaths. Among the 16 patients who received adjuvant treatment, 1 patient experienced relapse in the pelvis at 19 months. Conclusions: Primary retroperitoneal lymph node dissection for pure seminoma with low-volume metastases to the retroperitoneum is safe and effective, allowing most patients to avoid long-term toxicities from chemotherapy or radiation. © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Supplementary Materials Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.Keywordstesticular cancergerm cell tumorretroperitoneal lymph node dissectionMetrics Author Information Richard S. Matulewicz Memorial Sloan Kettering Cancer Center, Department of Surgery, Urology Service *Correspondence: 353 E. 68th Street, New York, NY 10065 (telephone: 646-422-4874; FAX: 646-888-6452; email: E-mail Address: [email protected]). More articles by this author Nicole Benfante Memorial Sloan Kettering Cancer Center, Department of Surgery, Urology Service More articles by this author Samuel A. Funt Memorial Sloan Kettering Cancer Center, Department of Medicine, Genitourinary Oncology Service More articles by this author Darren R. Feldman Memorial Sloan Kettering Cancer Center, Department of Medicine, Genitourinary Oncology Service More articles by this author Brett Carver Memorial Sloan Kettering Cancer Center, Department of Surgery, Urology Service More articles by this author Alexander Doudt Memorial Sloan Kettering Cancer Center, Department of Surgery, Urology Service More articles by this author Andrea Knezevic Memorial Sloan Kettering Cancer Center, Department of Epidemiology & Biostatistics More articles by this author Joel Sheinfeld Memorial Sloan Kettering Cancer Center, Department of Surgery, Urology Service More articles by this author Expand All Advertisement PDF downloadLoading ...