title: Postchemotherapy Retroperitoneal Lymph Node Dissection in Patients With Nonseminomatous Testicular Cancer: A Single Center Experiences.
abstract: BACKGROUND
  Testicular cancer accounts for about 1 - 1.5% of all malignancies in men. Radical orchiectomy is curative in 75% of patients with stage I disease, but advance stage with retroperitoneal lymph node involvement needs chemotherapy. All patients who have residual masses ≥ 1 cm after chemotherapy should undergo postchemotherapy retroperitoneal lymph node dissection (PC-RPLND).
  
  
  OBJECTIVE
  Treatment of advanced nonseminomatous testicular cancer is usually a combination of chemotherapy and surgery. We described our experience about postchemotherapy retroperitoneal lymph node dissection (PC-RPLND) in our center.
  
  
  METHODS
  In a retrospective cross-sectional study between 2006 and 2011, patients with a history of postchemotherapy retroperitoneal lymph node dissection (PC-RPLND) in Imam Khomeini hospital were evaluated. All patients had normal postchemotherapy serum tumor markers and primary nonseminomatous cancer. We reviewed retrospectively clinical, pathological, and surgical parameters associated with PC-RPLND in our center.
  
  
  RESULTS
  Twenty-one patients underwent bilateral PC-RPLND. Mean age was 26.3 years (ranged 16 - 47). Mean size of retroperitoneal mass after chemotherapy was 7.6 cm. Mean operative time was 198 minutes (120 - 246 minutes). Mean follow-up time was 38.6 months. Pathologic review showed presence of fibrosis/necrosis, viable germ cell tumor and teratoma in 8 (38.1%), 10 (47.6%) and 3 (14.28%) patients, respectively. One patient in postoperative period of surgery and three patients in two first years after surgery were expired. Of 17 alive patients, only two (11.8%) had not retrograde ejaculation.
  
  
  CONCLUSIONS
  PC-RPLND is one the major operations in the field of urology, which is associated with significant adjunctive surgeries. In appropriate cases, PC-RPLND was associated with good cancer specific survival in tertiary oncology center.
authors.affiliation: Uro-Oncology Research Center, Tehran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Mohamadreza
authors.initials: M
authors.lastname: Nowroozi
authors.affiliation: Uro-Oncology Research Center, Tehran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Ayati
authors.affiliation: Uro-Oncology Research Center, Tehran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Amir
authors.initials: A
authors.lastname: Arbab
authors.affiliation: Uro-Oncology Research Center, Tehran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Hassan
authors.initials: H
authors.lastname: Jamshidian
authors.affiliation: Department of Urology, Qazvin University of Medical Sciences, Qazvin, IR Iran.
authors.forename: Hamidreza
authors.initials: H
authors.lastname: Ghorbani
authors.affiliation: Uro-Oncology Research Center, Tehran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Hassan
authors.initials: H
authors.lastname: Niroomand
authors.affiliation: Uro-Oncology Research Center, Tehran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Taheri Mahmoodi
authors.affiliation: Uro-Oncology Research Center, Tehran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Erfan
authors.initials: E
authors.lastname: Amini
authors.affiliation: Department of Urology, Qazvin University of Medical Sciences, Qazvin, IR Iran.
authors.forename: Sohrab
authors.initials: S
authors.lastname: Salehi
authors.affiliation: Department of Urology, Qazvin University of Medical Sciences, Qazvin, IR Iran.
authors.forename: Hamid
authors.initials: H
authors.lastname: Hakima
authors.affiliation: Uro-Oncology Research Center, Tehran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Farid
authors.initials: F
authors.lastname: Fazeli
authors.affiliation: Department of Urology, Shahid Hasheminejad Hospital, Iran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Saeid
authors.initials: S
authors.lastname: Haghdani
authors.affiliation: Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Ghadian
keywords: Germ Cell Tumor; Teratoma; Tumor