Pelvic Lymph Node Dissection in Patients Treated for Testis Cancer: the Memorial Sloan-Kettering Cancer Center Experience

To describe the pathologic findings and clinical outcome data for patients undergoing pelvic lymph node dissection (PLND) in the course of management of testicular germ cell tumors at Memorial Sloan-Kettering Cancer Center (MSKCC).

Following institutional review board approval, data on 2186 patients who underwent retroperitoneal lymph node dissection (RPLND) at MSKCC between 1989 and 2011 was retrospectively reviewed. Of these 2186 patients, we analyzed data for 44 patients (2%) who underwent PLND at the time of RPLND.

PLND was performed in 14/44 (31%) patients at time of primary RPLND (P-RPLND), and in 21/44(48%) patients at time of post-chemotherapy RPLND (PC-RPLND), usually for suspicious radiologic or intraoperative findings, while 9/44(21%) underwent PLND for treatment of relapse. Positive pelvic findings on imaging included pelvic disease ≤5 cm in 17/44 (39%) patients and >5 cm in 11/44 (25%) patients (median size=4 cm). At the time of PC-RLND, alpha-fetoprotein (AFP) and beta human chorionic gonadotropin (BHCG) were elevated in 6/21 (29%) and 4/21 (19%) patients, respectively. Histology revealed teratoma in 15/44 (34%), and viable tumor in 5/44 (11%) patients. At a median follow-up of 46 months, 40/44 (91%) patients were living without disease, 3/44 (7%) were living with disease (1 after PC-RPLND and 2 after relapse), and 1/44 (2%) died of other causes.

PLND was performed infrequently in our series of patients who underwent RPLND for testis cancer. Teratoma was the dominant tumor histology in the resected tissue.

Urology. 2016 May 25 [Epub ahead of print]

Shaheen R Alanee, Brett S Carver, Darren R Feldman, Robert J Motzer, George J Bosl, Joel Sheinfeld

Division of Urology, Southern Illinois University School of Medicine, Springfield, IL., Division of Urology, Memorial Sloan-Kettering Cancer Center, New York, NY., Genitourinary Oncology Services, Memorial Sloan-Kettering Cancer Center, New York, NY, USA., Genitourinary Oncology Services, Memorial Sloan-Kettering Cancer Center, New York, NY, USA., Genitourinary Oncology Services, Memorial Sloan-Kettering Cancer Center, New York, NY, USA., Division of Urology, Memorial Sloan-Kettering Cancer Center, New York, NY.

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