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Unilateral or Bilateral Retroperitoneal Lymph Node Dissection in Nonseminoma Patients with Postchemotherapy Residual Tumour? Results from RETROP, a Population-based Mapping Study by the Swedish Norwegian Testicular Cancer Group

Gerdtsson, Axel LU ; Thor, Anna ; Grenabo Bergdahl, Anna ; Almås, Bjarte ; Håkansson, Ulf LU ; Törnblom, Magnus ; Negaard, Helene F.S. ; Glimelius, Ingrid ; Halvorsen, Dag and Karlsdóttir, Ása , et al. (2022) In European Urology Oncology 5(2). p.235-243
Abstract

BACKGROUND: The distribution of retroperitoneal lymph node metastases for patients with nonseminoma and a residual tumour of 10-49 mm in a population-based setting is unknown. This information is needed to justify selection of patients for a unilateral template resection. OBJECTIVE: To describe the location of retroperitoneal metastases and recurrences in patients with nonseminoma germ cell tumour (NSGCT) with a residual tumour of 10-49 mm. DESIGN, SETTING, AND PARTICIPANTS: RETROP is a population-based prospective observational mapping study of 213 patients in Sweden and Norway with a retroperitoneal residual tumour of 10-49 mm who underwent postchemotherapy retroperitoneal lymph node dissection for metastatic NSGCT during 2007-2014... (More)

BACKGROUND: The distribution of retroperitoneal lymph node metastases for patients with nonseminoma and a residual tumour of 10-49 mm in a population-based setting is unknown. This information is needed to justify selection of patients for a unilateral template resection. OBJECTIVE: To describe the location of retroperitoneal metastases and recurrences in patients with nonseminoma germ cell tumour (NSGCT) with a residual tumour of 10-49 mm. DESIGN, SETTING, AND PARTICIPANTS: RETROP is a population-based prospective observational mapping study of 213 patients in Sweden and Norway with a retroperitoneal residual tumour of 10-49 mm who underwent postchemotherapy retroperitoneal lymph node dissection for metastatic NSGCT during 2007-2014 with median follow-up of 100 mo. Patients were classified according to the testis primary tumour and the distribution of unilateral or bilateral lymph node metastases (with reference to the aorta) present on pre- and/or postchemotherapy computed tomography (CT) scans. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The distribution and rate of teratoma or cancer in unilateral or bilateral retroperitoneal fields and the location and rate of retroperitoneal recurrence were measured. RESULTS AND LIMITATIONS: In total, 65% of the patients had unilateral retroperitoneal lymph node metastases (RLNMs) on CT scans. Patients with unilateral RLNMs had a low risk of contralateral teratoma or cancer (1.6% for right- and 2.6% for left-sided NSGCT) or retroperitoneal recurrence (0% for right- and 4% for left-sided NSGCT). A weakness of the study is that the pathology specimen could not be fully designated to one specific area for some of the patients. CONCLUSIONS: Men with postchemotherapy residual disease of 10-49 mm and unilateral metastases on pre- and postchemotherapy CT scans have a low risk of contralateral disease and should be considered for a unilateral template resection. PATIENT SUMMARY: The surgeon can use computed tomography (CT) scans in deciding on the extent of lymph node dissection in patients with testicular cancer.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Bilateral, Mapping study, Nonseminoma, Postchemotherapy retroperitoneal lymph node dissection, Recurrence, Testicular cancer, Unilateral
in
European Urology Oncology
volume
5
issue
2
pages
9 pages
publisher
Elsevier
external identifiers
  • scopus:85130003234
  • pmid:33750683
ISSN
2588-9311
DOI
10.1016/j.euo.2021.02.002
language
English
LU publication?
yes
additional info
Publisher Copyright: Copyright © 2021 European Association of Urology. Published by Elsevier B.V. All rights reserved.
id
2683ee7e-0636-4649-9346-7003575eb81f
date added to LUP
2022-08-18 16:03:59
date last changed
2024-12-12 00:51:57
@article{2683ee7e-0636-4649-9346-7003575eb81f,
  abstract     = {{<p>BACKGROUND: The distribution of retroperitoneal lymph node metastases for patients with nonseminoma and a residual tumour of 10-49 mm in a population-based setting is unknown. This information is needed to justify selection of patients for a unilateral template resection. OBJECTIVE: To describe the location of retroperitoneal metastases and recurrences in patients with nonseminoma germ cell tumour (NSGCT) with a residual tumour of 10-49 mm. DESIGN, SETTING, AND PARTICIPANTS: RETROP is a population-based prospective observational mapping study of 213 patients in Sweden and Norway with a retroperitoneal residual tumour of 10-49 mm who underwent postchemotherapy retroperitoneal lymph node dissection for metastatic NSGCT during 2007-2014 with median follow-up of 100 mo. Patients were classified according to the testis primary tumour and the distribution of unilateral or bilateral lymph node metastases (with reference to the aorta) present on pre- and/or postchemotherapy computed tomography (CT) scans. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The distribution and rate of teratoma or cancer in unilateral or bilateral retroperitoneal fields and the location and rate of retroperitoneal recurrence were measured. RESULTS AND LIMITATIONS: In total, 65% of the patients had unilateral retroperitoneal lymph node metastases (RLNMs) on CT scans. Patients with unilateral RLNMs had a low risk of contralateral teratoma or cancer (1.6% for right- and 2.6% for left-sided NSGCT) or retroperitoneal recurrence (0% for right- and 4% for left-sided NSGCT). A weakness of the study is that the pathology specimen could not be fully designated to one specific area for some of the patients. CONCLUSIONS: Men with postchemotherapy residual disease of 10-49 mm and unilateral metastases on pre- and postchemotherapy CT scans have a low risk of contralateral disease and should be considered for a unilateral template resection. PATIENT SUMMARY: The surgeon can use computed tomography (CT) scans in deciding on the extent of lymph node dissection in patients with testicular cancer.</p>}},
  author       = {{Gerdtsson, Axel and Thor, Anna and Grenabo Bergdahl, Anna and Almås, Bjarte and Håkansson, Ulf and Törnblom, Magnus and Negaard, Helene F.S. and Glimelius, Ingrid and Halvorsen, Dag and Karlsdóttir, Ása and Sagstuen Haugnes, Hege and Engen Andreassen, Kristine and Melsen Larsen, Signe and Holmberg, Göran and Wahlqvist, Rolf and Tandstad, Torgrim and Cohn-Cedermark, Gabriella and Ståhl, Olof and Kjellman, Anders}},
  issn         = {{2588-9311}},
  keywords     = {{Bilateral; Mapping study; Nonseminoma; Postchemotherapy retroperitoneal lymph node dissection; Recurrence; Testicular cancer; Unilateral}},
  language     = {{eng}},
  month        = {{04}},
  number       = {{2}},
  pages        = {{235--243}},
  publisher    = {{Elsevier}},
  series       = {{European Urology Oncology}},
  title        = {{Unilateral or Bilateral Retroperitoneal Lymph Node Dissection in Nonseminoma Patients with Postchemotherapy Residual Tumour? Results from RETROP, a Population-based Mapping Study by the Swedish Norwegian Testicular Cancer Group}},
  url          = {{http://dx.doi.org/10.1016/j.euo.2021.02.002}},
  doi          = {{10.1016/j.euo.2021.02.002}},
  volume       = {{5}},
  year         = {{2022}},
}