WASHINGTON, DC USA (UroToday.com) - Dr. Richard Foster argued for open retroperitoneal lymph node dissection (RPLND).
He began by stating that the effectiveness of chemotherapy has made the outcomes for stage I disease similar for different treatment options. Surgery should be diagnostic, therapeutic and with low morbidity. He reported that 99% of patients retained antegrade ejaculation and 73% were able to father a child. The retroperitoneal relapse rate is 0.3% for open surgery. A laparoscopic retroperitoneal series showed a 1.4% relapse rate, and another study reported 4%. He showed a series of reports suggesting more frequent and more serious complications with laparoscopy around RPLND.
Dr. Sam Bhayani argued for laparoscopic RPLND. He attempted to refute all allegations that lap RPLND is inferior. He stated that with lap RPLND there is complete access to all nodes in the RP, with comparable node counts and comparable or lower recurrence rates. Regarding the allegation that the pneumoperitoneum can disseminate cancer, he argued that it is in fact protective against tumor spread.
Open: Richard Foster, MD. Indiana University Medical Center
Laparoscopic: Sam Bhayani, MD. Washington University School of Medicine
Presented by Christopher Saigal, MD at the Society for Basic Urologic Research (SBUR)/Society of Urologic Oncology (SUO) joint meeting during the American Urological Association (AUA) Annual Meeting - May 14 - 19, 2011 - Walter E. Washington Convention Center, Washington, DC USA
Reported for UroToday by Christopher P. Evans, MD, FACS, Professor and Chairman, Department of Urology, University of California, Davis, School of Medicine.