title: Utilization of retroperitoneal lymph node dissection for testicular cancer in the United States: Results from the National Cancer Database (1998-2011).
abstract: Retroperitoneal lymph node dissection (RPLND) for the treatment of testicular cancer is a relatively rare and complex operation that may contribute to differences in utilization. We sought to characterize the use of RPLND between different categories of cancer center facilities in the United States.
  
  
  
  The National Cancer Database was queried for patients with germ cell tumors treated at different types of cancer centers between 1998 and 2011. The proportion of patients who underwent RPLND was stratified by stage and histology and then compared between treatment facilities. RPLND utilization was then compared between facility types as a function of time.
  
  
  
  A total of 59,652 patients met inclusion criteria and 5,475 (9.2%) underwent RPLND. The proportion of patients treated with RPLND for non-seminomatous germ cell tumor (NSGCT) was significantly different between cancer center types for all stages (P<0.001) and used most often in academic comprehensive cancer centers. There was no difference in the proportion of RPLND utilization for stage II and III seminoma stratified by treatment facility. There was a significantly decreased trend in the utilization of RPLND for stage I (P = 0.032) NSGCT whereas utilization was increased for stage III NSGCT (P≤0.001) over the study period.
  
  
  
  The proportion of patients undergoing RPLND for NSGCT varies significantly by the type of cancer center and is used most often in academic cancer centers. Utilization of RPLND decreased for stage I NSGCT and increased for stage III NSGCTs during the study period.
authors.affiliation: Institute of Urology, University of Southern California, Los Angeles, CA.
authors.forename: Cory M
authors.initials: CM
authors.lastname: Hugen
authors.affiliation: Institute of Urology, University of Southern California, Los Angeles, CA.
authors.forename: Brian
authors.initials: B
authors.lastname: Hu
authors.affiliation: Section of Urology, Virigina Mason Medical Center, Seattle, WA.
authors.forename: Claudio
authors.initials: C
authors.lastname: Jeldres
authors.affiliation: Institute of Urology, University of Southern California, Los Angeles, CA.
authors.forename: Claire
authors.initials: C
authors.lastname: Burton
authors.affiliation: Section of Urology, Virigina Mason Medical Center, Seattle, WA.
authors.forename: Craig R
authors.initials: CR
authors.lastname: Nichols
authors.affiliation: Section of Urology, Virigina Mason Medical Center, Seattle, WA.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Porter
authors.affiliation: Institute of Urology, University of Southern California, Los Angeles, CA. Electronic address: daneshma@med.usc.edu.
authors.forename: Siamak
authors.initials: S
authors.lastname: Daneshmand
mesh_terms: D000046:Academic Medical Centers / Q000706:statistics & numerical data; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002173:Cancer Care Facilities / Q000145:classification / Q000706:statistics & numerical data; D003131:Combined Modality Therapy; D016208:Databases, Factual; D006764:Hospitals, Community / Q000706:statistics & numerical data; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods / Q000706:statistics & numerical data* / Q000639:trends; D008207:Lymphatic Metastasis; D008297:Male; D009367:Neoplasm Staging; D009373:Neoplasms, Germ Cell and Embryonal / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D012187:Retroperitoneal Space; D012189:Retrospective Studies; D018239:Seminoma / Q000188:drug therapy / Q000556:secondary / Q000601:surgery; D013736:Testicular Neoplasms / Q000188:drug therapy / Q000601:surgery*; D014481:United States / Q000453:epidemiology
chemical_list: D000970:Antineoplastic Agents
keywords: Retroperitoneal lymph node dissection; Testicular cancer