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Unilateral post-chemotherapy robot-assisted retroperitoneal lymph node dissection in Stage II non-seminomatous germ cell tumor:A tertiary care experience

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Asian Journal of Urology 2023年第4期10卷 440-445页

作者： Dario Franzese Antonio Tufano Alessandro Izzo Raffaele Muscariello Giovanni Grimaldi Giuseppe Quarto Luigi Castaldo Sabrina Rossetti Savio Domenico Pandolfo sonia desicato Paola Del Prete Matteo Ferro Sandro Pignata Sisto Perdonà Department of Urology National Cancer InstitutePascale FoundationNaplesItaly Urology Unit Department of Maternal-Child and Urological Sciences“Sapienza”UniversityRomeItaly Department of Neurosciences Science of Reproduction and OdontostomatologyUniversity of Naples Federico IINaplesItaly Scientific Directorate Istituto Nazionale Tumori di NapoliIRCCS“G.Pascale”NaplesItaly Division of Urology European Institute of Oncology(IEO)IRCCSMilanItaly Division of Medical Oncology Department of Uro-Gynaecological OncologyIstituto Nazionale per lo Studio e la Cura dei Tumori“Fondazione G.Pascale”IRCCSNaplesItaly

Objective Post-chemotherapy retroperitoneal lymph node dissection(PC-RPLND)represents an integral component of the management of patients with non-seminomatous germ cell tumor(NSGCT).Modified templates have been proposed to minimize the surgical morbidity of the ***,the implementation of robotic surgery in this setting has been *** report our experience with unilateral post-chemotherapy robot-assisted retroperitoneal lymph node dissection(PC-rRPLND)for clinical Stages IIA and IIB *** A retrospective single institution review was performed including 33 patients undergoing PC-rRPLND for Stages IIA and IIB NSGCTs between January 2015 and February *** orchiectomy,patients were scheduled for chemotherapy with three cycles of *** with a residual tumor of<5 cm and an ipsilateral metastatic disease on pre-and post-chemotherapy CT scans were eligible for a unilateral template in absence of rising tumor *** statistics were provided for demographics,clinical characteristics,intraoperative and postoperative ***,oncological,and functional outcomes were *** Overall,7(21.2%)patients exhibited necrosis or fibrosis;14(42.4%)had mature teratoma;and 12(36.4%)had viable tumor at final *** median lymph node size at surgery was 25(interquartile range[IQR]21-36)*** operative time was 180(IQR 165-215)min and no major postoperative complications were *** ejaculation was preserved in 75.8%of *** follow-up was 26(IQR 19-30)months and a total of three recurrences were *** PC-rRPLND is a reliable and technically reproducible procedure with safe oncological outcomes and acceptable postoperative ejaculatory function in well selected patients with NSGCTs.

关键词： Testis tumor Robot-assisted retroperitoneal lymph node dissection Retroperitoneal lymph node dissection Non-seminomatous germ cell tumor Unilateral dissection Modified template Post-chemotherapy

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