Sentinel node biopsy in clinical stage I testicular cancer enables early detection of occult metastatic disease.

Autor: Blok JM; Department of Oncological Urology, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht, The Netherlands.; Department of Urology, Netherlands Cancer Institute, Amsterdam, The Netherlands., Kerst JM; Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands., Vegt E; Department of Nuclear Medicine, The Netherlands Cancer Institute, Amsterdam, The Netherlands., Brouwer OR; Department of Urology, Netherlands Cancer Institute, Amsterdam, The Netherlands., Meijer RP; Department of Oncological Urology, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht, The Netherlands.; Department of Urology, Netherlands Cancer Institute, Amsterdam, The Netherlands., Bosch JLHR; Department of Oncological Urology, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht, The Netherlands., Bex A; Department of Urology, Netherlands Cancer Institute, Amsterdam, The Netherlands., van der Poel HG; Department of Urology, Netherlands Cancer Institute, Amsterdam, The Netherlands., Horenblas S; Department of Oncological Urology, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht, The Netherlands.; Department of Urology, Netherlands Cancer Institute, Amsterdam, The Netherlands.
Jazyk: angličtina
Zdroj: BJU international [BJU Int] 2019 Sep; Vol. 124 (3), pp. 424-430. Date of Electronic Publication: 2019 Mar 28.
DOI: 10.1111/bju.14618
Abstrakt: Objectives: To report the long-term results of the sentinel node (SN) approach in patients with clinical stage I testicular tumours in our facility.
Patients and Methods: We conducted an analysis of 27 consecutive patients suspected of clinical stage I testicular germ cell tumour (TGCT) and treated with an SN procedure at our tertiary referral centre. SNs were identified using lymphoscintigraphy with or without single-photo-emission computed tomography with CT (SPECT/CT). Patients underwent laparoscopic retroperitoneal SN excision with inguinal orchiectomy. Patients with a tumour-positive SN underwent adjuvant treatment. Follow-up was conducted according to then-current guidelines.
Results: In two patients, no SNs were visualized on scintigraphy. In the remaining 25 patients, a median (range) of 3 (1-4) SNs per patient were removed. Two patients showed no malignancy on histopathological examination of the testis. Of the 23 patients diagnosed with TGCT (16 seminomas, seven non-seminomas), three (13.0%) had occult metastatic disease. All 23 patients were without evidence of disease at a median (range) follow-up of 63.9 (29.0-143.4) months.
Conclusion: The SN procedure allows early identification of patients with occult metastatic disease in clinical stage I TGCT, enabling early treatment.
(© 2018 The Authors BJU International Published by John Wiley & Sons Ltd on behalf of BJU International.)
Databáze: MEDLINE
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