Switch to
| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:issue |
4
|
| pubmed:dateCreated |
1990-6-28
|
| pubmed:abstractText |
We present 8 years' experience of primary retroperitoneal lymph node dissection (RLND) in 190 patients with low stage non-seminoma; 154 patients had clinical stage I (CSI) and 36 had clinical stage IIa (CSIIa) disease. Of the 154 patients with CSI tumours, 33 had increased serum AFP and/or HCG before RLND (CSIM+) and 121 had normal tumour markers (CSIM-). Retroperitoneal lymph node metastases (pathological stage II) (PSII) were found in 38 of 121 patients with CSIM-, in 19 of 33 patients with CSIIM+ and in 26 of 36 patients with CSIIa. In a multivariate analysis, the presence of small vessel infiltration (demonstrated in histological sections of the primary tumour) and a prolonged tumour marker half-life were predictive factors for PSII. These 2 factors enabled a group of non-seminoma patients with CSI disease to be identified who had a 15% risk of retroperitoneal tumour growth (low risk group) as compared with a high risk group where 60 to 70% of patients had retroperitoneal lymph node metastases. Relapses occurred in 7 of 107 patients with PSI and in 6 of 83 patients with PSII disease; in the latter group, 5 relapses developed before the start of routine adjuvant chemotherapy; 6% of patients developed major post-operative complications. In addition, "dry ejaculation" was the principal side effect following RLND (unilateral RLND: 20/132 patients; bilateral RLND: 50/54 patients). The comparative cost to the health service during the first year of follow-up was estimated for low risk non-seminoma patients with CSI subjected to RLND and for those in whom a surveillance policy was adopted. The latter approach was preferable. It was concluded that a surveillance policy should be followed in low risk non-seminoma CSI patients provided that frequent follow-up is possible. A more active policy is recommended in high risk patients (e.g. adjuvant chemotherapy without RLND). Nerve-sparing RLND may be considered in patients with CSIIa disease and negative tumour markers.
|
| pubmed:language |
eng
|
| pubmed:journal | |
| pubmed:citationSubset |
IM
|
| pubmed:chemical | |
| pubmed:status |
MEDLINE
|
| pubmed:month |
Apr
|
| pubmed:issn |
0007-1331
|
| pubmed:author | |
| pubmed:issnType |
Print
|
| pubmed:volume |
65
|
| pubmed:owner |
NLM
|
| pubmed:authorsComplete |
Y
|
| pubmed:pagination |
385-90
|
| pubmed:dateRevised |
2004-11-17
|
| pubmed:meshHeading |
pubmed-meshheading:2340372-Adolescent,
pubmed-meshheading:2340372-Adult,
pubmed-meshheading:2340372-Ejaculation,
pubmed-meshheading:2340372-Humans,
pubmed-meshheading:2340372-Lymph Node Excision,
pubmed-meshheading:2340372-Lymphatic Metastasis,
pubmed-meshheading:2340372-Male,
pubmed-meshheading:2340372-Middle Aged,
pubmed-meshheading:2340372-Neoplasm Recurrence, Local,
pubmed-meshheading:2340372-Neoplasm Staging,
pubmed-meshheading:2340372-Postoperative Complications,
pubmed-meshheading:2340372-Predictive Value of Tests,
pubmed-meshheading:2340372-Retroperitoneal Space,
pubmed-meshheading:2340372-Teratoma,
pubmed-meshheading:2340372-Testicular Neoplasms,
pubmed-meshheading:2340372-Tumor Markers, Biological
|
| pubmed:year |
1990
|
| pubmed:articleTitle |
Is routine primary retroperitoneal lymph node dissection still justified in patients with low stage non-seminomatous testicular cancer?
|
| pubmed:affiliation |
Department of Medical Oncology, Norwegian Radium Hospital, Oslo.
|
| pubmed:publicationType |
Journal Article
|