Post-chemotherapy retroperitoneal lymph node dissection (PC-RPLND) is an important tool in the management of advanced germ cell testis cancer, particularly non-seminoma.
We present the 16-year experience with PC-RPLND in a single Irish tertiary referral centre, and compare our results to the major speciality centres worldwide.
All 78 patients undergoing PC-RPLND for the treatment of metastatic testis cancer between January 1996 and December 2011 were included. Medical records were reviewed and up to date follow-up obtained from primary referral centres, patient's GPs and individual patient interview.
The mean age at diagnosis was 28. 5 ± 7 years. Initial pathology included non-seminoma 62. 8 %, seminoma 6. 4 % and combined 19. 2 %. All patients underwent pre-operative chemotherapy. The resection template utilised was bilateral infra-hilar in 29. 5 %, unilateral infra-hilar in 46. 2 % and supra-hilar in 20. 5 %. Complete abdominal remission was achieved in all but one patient. Additional procedures were required in 38. 5 % of patients (n = 30). Clavien Dindo grade three or four complications were seen in 8. 9 %, including five patients who required early reoperation. Histology of RPLND specimen showed mature teratoma (41 %) and active cancer (11. 5 %). Follow-up data were available for 66 patients (85 %). Median follow-up was 101 (11-207) months. Nine patients relapsed with median time to relapse 15 (8-60) months. Overall 5-year survival rate was 95. 2 % (four deaths).
In this relatively small series due to small population and low disease incidence, we have shown acceptable peri-operative course, morbidity and oncological outcomes with PC-RPLND compared to major international centres.
Irish journal of medical science. 2015 Dec 21 [Epub ahead of print]
S Considine, R Heaney, R Conroy, J A Thornhill
Department of Urology, Tallaght Hosptial, Dublin 24, Ireland. Department of Urology, Tallaght Hosptial, Dublin 24, Ireland. , Department of Epidemiology and Public Health Medicine, Royal College of Surgeons in Ireland, Dublin 2, Ireland. , Department of Urology, Tallaght Hosptial, Dublin 24, Ireland.