Robotic Assisted Retroperitoneal Lymph Node Dissection for Small Volume Metastatic Testicular Cancer

Autor: Carolin Buddensieck, Christian Arsov, Andreas Hiester, Alessandro Nini, Peter Albers
Rok vydání: 2020
Předmět:
Male
Robotic assisted
medicine.medical_treatment
Blood Loss
Surgical
030232 urology & nephrology
Retroperitoneal lymph node dissection
Postoperative Complications
0302 clinical medicine
Robotic Surgical Procedures
Prospective Studies
Middle Aged
Neoadjuvant Therapy
Seminoma
Treatment Outcome
surgical procedures
operative
medicine.anatomical_structure
Chemotherapy
Adjuvant
Lymphatic Metastasis
Radiology
Adult
medicine.medical_specialty
Adverse outcomes
Urology
Operative Time
Young Adult
03 medical and health sciences
Testicular Neoplasms
medicine
Humans
Retroperitoneal space
Retroperitoneal Space
Testicular cancer
Aged
Neoplasm Staging
Retrospective Studies
business.industry
Small volume
Metastatic Testicular Cancer
technology
industry
and agriculture
Length of Stay
medicine.disease
body regions
Feasibility Studies
Lymph Node Excision
Lymph Nodes
Neoplasm Recurrence
Local
business
human activities
Follow-Up Studies
Zdroj: Journal of Urology. 204:1242-1248
ISSN: 1527-3792
0022-5347
DOI: 10.1097/ju.0000000000001301
Popis: Robotic assisted retroperitoneal lymph node dissection in patients with testicular cancer is controversial. Lately, unusual recurrence patterns with adverse outcomes after robotic assisted retroperitoneal lymph node dissection have been published. In this report we determine the feasibility, safety and early oncologic outcome of robotic assisted retroperitoneal lymph node dissection in patients with small volume metastatic testicular cancer.We retrospectively evaluated 27 consecutive patients with small volume metastatic testicular cancer (October 2010 to November 2019) who underwent robotic assisted retroperitoneal lymph node dissection (unilateral modified template). Intraoperative and postoperative complications as well as early oncologic outcomes are reported. Surgery was performed in the primary metastatic setting in 22 (81%), post-chemotherapy in 4 (15%) and for late relapse in 1 patient (4%). Initial clinical stage was IIA for 14 (52%), IIB for 12 (43%) and III for 1 (4%) patient.Median operative time, blood loss and length of hospital stay were 175 minutes, 50 ml and 4 days, respectively. Expectedly, viable tumor was found in 21/27 patients (78%) and 6 patients (22%) showed fibrosis, necrosis or no tumor. Overall 3 (11%) patients experienced intraoperative (Satava II) and 1 (4%) postoperative (Clavien-Dindo IIIb) complications, respectively. Median followup was 16.5 months (3-69), and 3 (11%) patients experienced relapse outside of the surgical field after 12, 22 and 36 months.In highly selected patients with low volume metastatic testicular cancer robotic assisted retroperitoneal lymph node dissection may be indicated, and appears to be technically feasible and comparable with open surgery in terms of complications and early oncologic safety. Prospective data collection in larger series is necessary to clarify the role and specific indications of this approach.
Databáze: OpenAIRE
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