title: Role of postchemotherapy retroperitoneal lymph node dissection in advanced germ cell tumors.
abstract: Advanced germ cell tumors (GCTs) are curable with the appropriate integration of cisplatin-based chemotherapy and postchemotherapy surgical resection of residual masses. For men with retroperitoneal metastases, postchemotherapy retroperitoneal lymph node dissection (PC-RPLND) is a vital component of this treatment algorithm. The rationale for PC-RPLND is based on the consistent 10% to 20% and 35% to 55% incidence of viable malignancy and teratoma, respectively. Prognostic factors and nomograms cannot predict the presence of necrosis with sufficient accuracy to obviate the need for PC-RPLND. This article reviews the indications, technique, and outcomes of PC-RPLND in the management of advanced GCT.
authors.affiliation: Glickman Urological and Kidney Institute, Cleveland Clinic, 9500 Euclid Avenue, Q10, Cleveland, OH 44195, USA.
authors.forename: Carvell T
authors.initials: CT
authors.lastname: Nguyen
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Stephenson
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods*; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D012187:Retroperitoneal Space; D018239:Seminoma / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D013736:Testicular Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome
chemical_list: D002945:Cisplatin