[Value of retroperitoneal lymphadenectomy for germ cell cancer].
Retroperitoneal lymph node dissection (RPLND) is an integral part in the therapy of nonseminomatous germ cell tumors. However, there has been a shift concerning the indication. For a long period RPLND was the primary choice in clinical stage I nonseminoma. Nowadays a risk-adapted strategy is preferred. RPLND is obligatory after finishing chemotherapy in metastasized patients if residual tumor is seen. In cases of a late relapse surgery is much more important than chemotherapy independent of increased tumor markers. RPLND can also be a salvage strategy in chemoresistant patients. About 25% of these patients have a long-term benefit. Open or laparoscopic surgery can be performed, though the indications for laparoscopy are small.
Krege
S
S
Klinik für Urologie und Kinderurologie, Krankenhaus Maria Hilf, Oberdiessemerstrasse 94, 47805 Krefeld. susanne.krege@maria-hilf.de
D006801:Humans; D008197:Lymph Node Excision / Q000379:methods*; D008207:Lymphatic Metastasis; D009373:Neoplasms, Germ Cell and Embryonal / Q000556:secondary* / Q000601:surgery*; D012187:Retroperitoneal Space / Q000601:surgery*; D014571:Urologic Neoplasms / Q000601:surgery*