Current Status of Retroperitoneal Lymph Node Dissection and Testicular Cancer: When to Operate

Richard Foster, MD; Richard Bihrle, MD


Cancer Control. 2002;9(4) 

In This Article


In low-stage disease, the surgical removal of involved retroperitoneal lymph nodes has a solid rationale. The morbidity of nerve-sparing RPLND is low, and many patients who undergo removal of retroperitoneal metastatic disease are cured with surgical therapy alone, thereby avoiding chemotherapy. In postchemotherapy disease, the rationale for removing these retroperitoneal masses is strong. Approximately 60% to 70% of the time, the mass will be composed of either teratoma or persistent cancer, and surgical removal may be therapeutic. In more complicated postchemotherapy disease such as late relapse or the removal of chemoresistant retroperitoneal cancer (desperation RPLND), 30% to 40% of these patients with chemo-resistant metastatic cancer can be cured with surgical therapy alone. These postchemotherapy procedures, however, can be technically challenging and require specialized vascular capabilities. Similarly, the appearance of the tumor on CT scans may not be a valid indication of the technical requirements for surgical removal. These difficult surgical procedures require diverse technical capabilities and a commitment to a sometimes lengthy and arduous procedure.

CME Information

This article was originally certified for CME credit. For accreditation details, contact the publisher.
H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, Tampa, FL 33612. Telephone: (813) 632-1349. Fax: (813) 903-4950. Email: Cancer Control is included in Index Medicus/MEDLINE and EMBASE/Excerpta Medica.)

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