Sentinel Node Biopsy in Clinical Stage I Testicular Cancer Enables Early Detection of Occult Metastatic Disease.

To report the long-term results of the sentinel node approach in clinical stage I testicular tumour patients in our facility.

Analysis of 27 consecutive patients suspected of clinical stage I testicular germ cell tumour and treated with a sentinel node procedure at our tertiary referral centre. Sentinel nodes were identified using lymphoscintigraphy with or without single photo emission computed tomography with computed tomography. Patients underwent laparoscopic retroperitoneal sentinel node excision with inguinal orchiectomy. Patients with a tumour-positive sentinel node underwent adjuvant treatment. Follow-up was according to then current guidelines.

In two patients, no sentinel nodes were visualized on scintigraphy. In the remaining twenty-five patients, a median of 3 sentinel nodes (range 1 - 4) per patient were removed. Two patients showed no malignancy on histopathological examination of the testis. Of the 23 patients diagnosed with testicular germ cell tumour (16 seminoma, 7 non-seminoma), 3 (13.0%) had occult metastatic disease. All 23 patients were without evidence of disease at a median follow-up of 63.9 months (range 29.0 - 143.4).

The sentinel node procedure allows for early identification of patients with occult metastatic disease in clinical stage I testicular germ cell tumour, enabling early treatment. This article is protected by copyright. All rights reserved.

BJU international. 2018 Nov 11 [Epub ahead of print]

Joost M Blok, J Martijn Kerst, Erik Vegt, Oscar R Brouwer, Richard P Meijer, J L H Ruud Bosch, Axel Bex, Henk G van der Poel, Simon Horenblas

Department of Oncological Urology, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht, The Netherlands., Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands., Department of Nuclear Medicine, The Netherlands Cancer Institute, Amsterdam, The Netherlands., Department of Urology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.

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