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• W2316096346 abstract "You have accessJournal of UrologySexual Function/Dysfunction/Andrology: Penis/Testis/Urethra: Malignant Disease1 Apr 2015MP10-02 RETROPERITONEAL LYMPH NODE DISSECTION AS FIRST-LINE TREATMENT FOR NODE POSITIVE SEMINOMA Brian Hu, Swar Shah, Sepehr Shojaei, and Siamak Daneshmand Brian HuBrian Hu More articles by this author , Swar ShahSwar Shah More articles by this author , Sepehr ShojaeiSepehr Shojaei More articles by this author , and Siamak DaneshmandSiamak Daneshmand More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.403AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The long-term morbidity associated with treating advanced seminoma can be significant. Retroperitoneal lymph node dissection (RPLND) has established oncologic efficacy in germ cell tumors and minimal long-term toxicity. We describe our experience with RPLND as a front-line treatment for lymph node positive seminoma. METHODS We reviewed our IRB-approved testis cancer database including patients with pure seminoma and low volume isolated retroperitoneal lymph node disease treated with primary RPLND. Clinical and pathologic variables were obtained. Follow-up data was used to determine recurrence or death. RESULTS Four patients with a mean age of 37 years were identified. All patients had normal tumor markers and retroperitoneal lymphadenopathy measuring 1.1, 1.5, 1.8 and 5.5 cm prior to RPLND. Three patients had seminoma diagnosed at orchiectomy and one patient (with 5.5cm retroperitoneal lymphadenopathy and burned out primary testis mass) had seminoma diagnosed at RPLND after 2 non-diagnostic retroperitoneal biopsies. All patients underwent nerve-sparing template extraperitoneal RPLND and were discharged home after three days. All patients had pathologic stage IIA disease with a mean of 3 positive lymph nodes. No patients underwent adjuvant therapy. With a mean follow-up of 24 months, no patients experienced disease recurrence or death. There was one short-term complication of an ileus. All patients maintained antegrade ejaculation and there were no long-term complications. CONCLUSIONS Our small series demonstrated encouraging oncologic efficacy when RPLND was used as a primary treatment for stage IIA retroperitoneal seminoma. A multi-institutional phase II trial of RPLND in this disease space is being developed. Patient Characteristics Patient Orchiectomy pathology Retroperitoneal mass prior to RPLND (cm) Number of positive lymph nodes Total number of lymph nodes removed Largest positive lymph node (cm) Retroperitoneal pathology 1 Pure seminoma 1.1 5 55 1.5 Pure seminoma 2 Pure seminoma 1.5 2 20 0.7 Pure seminoma 3 Pure seminoma 1.8 2 35 2 Pure seminoma 4 Scar with dystrophic calcification 5.5 4 48 1.9 Pure seminoma © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e110 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Brian Hu More articles by this author Swar Shah More articles by this author Sepehr Shojaei More articles by this author Siamak Daneshmand More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ..." @default.
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• W2316096346 title "MP10-02 RETROPERITONEAL LYMPH NODE DISSECTION AS FIRST-LINE TREATMENT FOR NODE POSITIVE SEMINOMA" @default.
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