Can selective retroperitoneal lymphadenectomy be better than unilateral retroperitoneal lymphadenectomy?



Título del documento: Can selective retroperitoneal lymphadenectomy be better than unilateral retroperitoneal lymphadenectomy?
Revista: International braz j urol
Base de datos: PERIÓDICA
Número de sistema: 000296418
ISSN: 1677-5538
Autores: 1



Instituciones: 1Universidade Federal de Sao Paulo, Escola Paulista de Medicina, Ribeirao Preto, Sao Paulo. Brasil
Año:
Periodo: Sep-Oct
Volumen: 29
Número: 5
Paginación: 412-417
País: Brasil
Idioma: Inglés
Tipo de documento: Artículo
Enfoque: Caso clínico, analítico
Resumen en inglés OBJECTIVE: To propose a new modality of retroperitoneal lymphadenectomy as a complementary treatment for patients with high risk, stage I nonseminomatous testicular tumor. MATERIALS AND METHODS: We studied 76 patients with stage I nonseminomatous testis tumor (T1-T4, NX, M0) treated by orchiectomy and retroperitoneal lymphadenectomy. Among them, 33 patients underwent unilateral retroperitoneal lymphadenectomy (URL) and 43 selective retroperitoneal lymphadenectomy (SRL). URL consisted in removing the lymph nodes located around the great vessel homolateral to the tumor (aorta or vena cava and iliac vessels), and anterior and posterior to the contralateral great vessel (aorta or vena cava). SRL was performed removing the lymph nodes located anterior and between the great vessels (aorta or vena cava) and laterally to the homolateral great vessel, extending the distal dissection until the level of inferior mesenteric artery. In these groups of patients, the incidence of disease recurrence, disease-free survival index, and frequency of post-operative aspermia were assessed. Mean post-operative follow-up time was 96 months. RESULTS: In the SRL group there was only 5% of aspermia versus 79% in the URL group (p < 0.0001). Tumor recurrence was observed in only 5 of the 76 patients and was not related to the surgical technique. The disease-free survival rate after the mean follow-up of 96 months was similar in both groups, being 94% in the SRL group and 93% in the URL group. CONCLUSION: The selective retroperitoneal lymphadenectomy constit
Disciplinas: Medicina
Palabras clave: Cirugía,
Oncología,
Testículos,
Neoplasias,
Tumores,
Células germinales,
Linfadenectomía,
Metástasis
Keyword: Medicine,
Oncology,
Surgery,
Testis,
Neoplasms,
Tumors,
Germ cells,
Lymphadenectomy,
Metastasis
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