Retroperitoneal lymph node dissection for high-risk stage I and stage IIA seminoma

Mezvrishvili, Zaza; Managadze, L.

doi:10.1007/s11255-005-4793-x

Cited by 28 publications

(18 citation statements)

References 30 publications

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“…17,18 The first study was an institutional review from the University Hospital of Magdeburg (Magdeburg, Germany), where RPLND was used for stage I and II seminoma. 17 Surgery was the preferred management at their institution until 1985.…”

Section: Discussionmentioning

confidence: 99%

“…1 The second study was from a group in Tbilisi, Georgia. 18 They evaluated primary RPLND between 1997 and 2002 for patients with high-risk stage I (n ¼ 10) and stage IIA (n ¼ 4) seminoma. 18 No patient had experienced local or distant recurrence at a mean follow-up period of 4.7 years.…”

Section: Discussionmentioning

confidence: 99%

“…Although representing a small sample size, the data compare favorably with the recurrence rates seen after EBRT and CT (Table 2). 11,12,17,18,[20][21][22][23][24][25][26][27] Most studies have examined the recurrence rate after EBRT, which has been 0% to 17%. The outcomes after cisplatin-based CT, although also of smaller sample sizes, have been favorable.…”

Section: Discussionmentioning

confidence: 99%

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Retroperitoneal Lymph Node Dissection as First-Line Treatment of Node-Positive Seminoma

Shah

Shojaei

et al. 2015

Clinical Genitourinary Cancer

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Retroperitoneal Lymph Node Dissection as First-Line Treatment of Node-Positive Seminoma

Shah

Shojaei

et al. 2015

Clinical Genitourinary Cancer

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“…Evidence supporting RPLND in seminoma is, however, sparse. 4 retrospective series, totaling 92 patients, only 37 of whom were stage II, have been published in detail or in abstract form [7,8,9,10]. Due to the low numbers and differing inclusion criteria, follow-up and use of adjuvant CT, it is difficult to estimate a precise relapse risk.…”

Section: Treatment Modalities For Csii Seminomamentioning

confidence: 99%

Clinical Stage IIA-IIC Seminoma: Radiation Therapy versus Systemic Chemotherapy versus Retroperitoneal Lymph Node Dissection

2018

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Background: Clinical stage II (CSII) seminoma is defined by the presence of pure seminoma accompanied by retroperitoneal lymph node metastases. In patients with bulky disease (lymph nodes > 5 cm in diameter), platinum-based chemotherapy is the widely accepted standard of care. However, the optimal choice of treatment for CSIIA and IIB is more controversial. Methods: We performed a PubMed search using the key words stage II seminoma, BEP (cisplatin, etoposide, and bleomycin), hockey-stick radiotherapy, dog-leg radiotherapy and retroperitoneal lymph node dissection. Most relevant publications were summarized for this review. Results: To date, no randomized trials have prospectively compared radiotherapy (RT), chemotherapy (CT) and retroperitoneal lymph node dissection (RLND) for CSII seminoma. Because of the predominantly retrospective analyses and only few prospective trials data interpretation is complex. In CSIIA with lymph nodes of < 2 cm, RT and CT seem to be equally effective, while in CSIIB, a decreased number of relapses were observed in CT-treated patients. In addition, RT seems to be associated with a higher incidence of long-term sequelae when compared with CT. Conclusion: Prospective clinical trials are needed to systematically compare the different treatment modalities. De-escalation of treatment intensity without loss of efficacy is required to improve long-term outcome for this young patient population.

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“…Although short‐term effectiveness of Carboplatin has been encouraging, the long term outcomes of patients treated with this approach are not yet clear 15,16 . RPLND has rarely been used in this setting and will not be discussed further 17,18 …”

Section: Introductionmentioning

confidence: 99%

Stage I seminoma: What should a practicing uro‐oncologist do in 2009?

Skliarenko¹,

Vesprini²,

Warde³

2009

Int J of Urology

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Testicular tumors are uncommon, but they continue to represent an important group of malignancies in young men. It is the most common solid malignancy in males between the ages of 20 and 35, and primary germ cell tumors are the most common histological type. In the United States in 2008, approximately 4800 cases of seminoma, approximately 4100 of which were stage I disease were projected after the completion of staging investigations.Remarkable progress has been made in the treatment of testicular seminoma over the past 25 years. Management options of stage I seminoma include radiotherapy, surveillance, or adjuvant chemotherapy. Standard management until recent years has been adjuvant retroperitoneal radiotherapy. Although providing excellent long term results, this approach has been associated with increased risk of gonadal toxicity, development of secondary malignancies and an increased risk of cardiovascular disease. The use of surveillance in management of patients with stage I seminoma is therefore becoming more frequent as it minimizes the burden of treatment and maintains the cure rate at virtually 100%. Adjuvant chemotherapy using Carboplatin has been investigated as an alternative management approach. However, the long term outcomes of patients managed with Carboplatin are not yet clear and this strategy should only be used in a study setting. It has been suggested that more patients with stage I seminoma will die of their treatment than of their cancer; therefore, the thrust of modern management should be to maintain 100% cure while minimizing the burden of treatment.

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Retroperitoneal lymph node dissection for high-risk stage I and stage IIA seminoma

Abstract: The excellent results and minimum morbidity of nerve-sparing RPLND together with the increased concerns on late complications of radiotherapy may turn the preference of surgery in low-stage seminoma into the subject of future discussion.

Cited by 28 publications

References 30 publications

Retroperitoneal Lymph Node Dissection as First-Line Treatment of Node-Positive Seminoma

Retroperitoneal Lymph Node Dissection as First-Line Treatment of Node-Positive Seminoma

Clinical Stage IIA-IIC Seminoma: Radiation Therapy versus Systemic Chemotherapy versus Retroperitoneal Lymph Node Dissection

Stage I seminoma: What should a practicing uro‐oncologist do in 2009?

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