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SYMPOSIUM
Year : 2010  |  Volume : 26  |  Issue : 1  |  Page : 102-107

Surgery for retroperitoneal relapse in the setting of a prior retroperitoneal lymph node dissection for germ cell tumor


1 Department of Urology, Memorial Sloan-Kettering Cancer Center, New York, USA
2 Department of Urology, Weill College of Medicine, New York, USA

Correspondence Address:
Joel Sheinfeld
Department of Urology, Weill College of Medicine, 353 East 68th Street, New York, NY 10021
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-1591.60452

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Recognition of the therapeutic role of retroperitoneal lymph node dissection (RPLND) in the setting of testicular germ cell tumors (GCTs) is of utmost importance. Although the histologic findings of RPLND provide diagnostic and prognostic information, the adequacy of initial RPLND is an independent predictor of clinical outcome. Despite the advent of effective cisplatin-based chemotherapy for testicular GCTs, patients who have undergone suboptimal surgery at the time of initial RPLND are compromised. Despite the initial enthusiasm surrounding anatomic mapping studies, the use of modified RPLND templates has the potential to leave a significant number of patients with unresected retroperitoneal disease. Teratomatous elements are particularly common. Patients with retroperitoneal relapse following initial RPLND should be treated with reoperative RPLND and chemotherapy and can expect long term survival rates nearing 70% when treated in tertiary centers by experienced surgeons.


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