Unilateral retroperitoneal lymph node dissection in patients with non-seminomatous testicular tumor in clinical stage I.
19 of 53 patients (36%) with non-seminomatous testicular cancer, clinical stage I (CS I), had retroperitoneal lymph node metastases, pathological stage II (PS II), demonstrated by retroperitoneal lymph node dissection (RLND). RLND was done unilaterally in peroperatively tumor-free patients (PS I: 34 patients; PS II: 3 patients) and bilaterally if metastatic lymph nodes were found peroperatively. Patients with PS II received adjuvant cis-platinum containing combination chemotherapy. Postoperative tumor activity was observed in 3 patients (median observation time: 31 months). They were cured by salvage chemotherapy. 12-18 months after RLND no ejaculatory disturbances were observed in 28 of 36 unilaterally operated patients. After unilateral RLND, 7 patients fathered children. Unilateral RLND seems to be a sufficient diagnostic procedure in patients with non-seminomatous testicular cancer, CS I, who were found tumor-free during the operation. Fertility is preserved in the majority of the unilaterally operated patients.
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004407:Dysgerminoma / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D005298:Fertility; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D009367:Neoplasm Staging; D012187:Retroperitoneal Space; D013736:Testicular Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery