title: Pelvic Lymph Node Dissection in Patients Treated for Testis Cancer: The Memorial Sloan Kettering Cancer Center Experience.
abstract: OBJECTIVE
  To describe the pathologic findings and clinical outcome data for patients undergoing pelvic lymph node dissection (PLND) in the course of management of testicular germ cell tumors at Memorial Sloan Kettering Cancer Center (MSKCC).
  
  
  METHODS
  Following institutional review board approval, data on 2186 patients who underwent retroperitoneal lymph node dissection (RPLND) at MSKCC between 1989 and 2011 were retrospectively reviewed. Of these 2186 patients, we analyzed data for 44 patients (2%) who underwent PLND at the time of RPLND.
  
  
  RESULTS
  PLND was performed in 14/44 (31%) patients at time of primary RPLND (P-RPLND), and in 21/44(48%) patients at time of postchemotherapy RPLND (PC-RPLND), usually for suspicious radiologic or intraoperative findings, whereas 9/44 (21%) underwent PLND for treatment of relapse. Positive pelvic findings on imaging included pelvic disease ≤5 cm in 17/44 (39%) patients and >5 cm in 11/44 (25%) patients (median size = 4 cm). At the time of PC-RPLND, alpha-fetoprotein and beta human chorionic gonadotropin were elevated in 6/21 (29%) and 4/21 (19%) patients, respectively. Histology revealed teratoma in 15/44 (34%) and viable tumor in 5/44 (11%) patients. At a median follow-up of 46 months, 40/44 (91%) patients were living without disease, 3/44 (7%) were living with disease (1 after PC-RPLND and 2 after relapse), and 1/44 (2%) died of other causes.
  
  
  CONCLUSIONS
  PLND was performed infrequently in our series of patients who underwent RPLND for testis cancer. Teratoma was the dominant tumor histology in the resected tissue.
authors.affiliation: Department of Surgery, Division of Urology, Southern Illinois University School of Medicine, Springfield, IL. Electronic address: salanee@siumed.edu.
authors.forename: Shaheen R
authors.initials: SR
authors.lastname: Alanee
authors.affiliation: Urology, Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Brett S
authors.initials: BS
authors.lastname: Carver
authors.affiliation: Genitourinary Oncology Services, Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Darren R
authors.initials: DR
authors.lastname: Feldman
authors.affiliation: Genitourinary Oncology Services, Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Motzer
authors.affiliation: Genitourinary Oncology Services, Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: George J
authors.initials: GJ
authors.lastname: Bosl
authors.affiliation: Urology, Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Joel
authors.initials: J
authors.lastname: Sheinfeld
mesh_terms: D000293:Adolescent; D002173:Cancer Care Facilities; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000473:pathology* / Q000556:secondary / Q000601:surgery*; D012189:Retrospective Studies; D013736:Testicular Neoplasms / Q000473:pathology* / Q000556:secondary / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult