Mp01-18 Post-Chemotherapy Retroperitoneal Lymph Node Dissection for Testicular Seminoma: Experience From Two Large Referral Centers

You have accessJournal of UrologyPenile & Testicular Cancer I (MP01)1 May 2024MP01-18 POST-CHEMOTHERAPY RETROPERITONEAL LYMPH NODE DISSECTION FOR TESTICULAR SEMINOMA: EXPERIENCE FROM TWO LARGE REFERRAL CENTERS Alireza Ghoreifi, Christina Steinbach, Farshad Sheybaee Moghaddam, David Pfister, Pia Paffenholz, Axel Heidenreich, and Siamak Daneshmand Alireza GhoreifiAlireza Ghoreifi , Christina SteinbachChristina Steinbach , Farshad Sheybaee MoghaddamFarshad Sheybaee Moghaddam , David PfisterDavid Pfister , Pia PaffenholzPia Paffenholz , Axel HeidenreichAxel Heidenreich , and Siamak DaneshmandSiamak Daneshmand View All Author Informationhttps://doi.org/10.1097/01.JU.0001008660.87408.90.18AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Surgical resection of post-chemotherapy residual masses following chemotherapy (PC-RPLND) for seminoma poses a significant challenge given the intense desmoplastic reaction that results from treatment. Limited data exist from small case series in this setting. The aim of this study is to report the outcomes of patients with seminoma who underwent PC-RPLND. METHODS: In this retrospective study, we included patients who underwent PC-RPLND for pure seminoma at two large referral centers in the United States and Germany between 2000 and 2023. Those with insufficient clinical data were excluded. Perioperative and long-term outcomes of the patients were reviewed. RESULTS: A total of 52 patients with a median (IQR) age of 39 (32–49) years were included. All patients received first-line cisplatin-based chemotherapy, and 9 required salvage chemotherapy. Clinical features of the patients are presented in Table 1. Preoperative tumor markers were normal in all patients. Most surgeries were performed through a midline abdominal approach (n=49, 94%), including 7 extraperitoneal, and 3 patients underwent robotic PC-RPLND. Resection templates included full bilateral in 50% and modified in 50%. Post-ganglionic nerves were preserved in 14 (27%) patients. Additional intraoperative procedures were performed in 28 (54%) cases, the most common of which were vascular resection/repair (19%) and ureteral resection/repair (19%), followed by nephrectomy (11.5%). Median (IQR) blood loss and length of hospital stay were 500 (400–825) mL and 4 (2–6) days, respectively. The 90-day complication rate was 17% (most common: lymphocele). Final pathology revealed necrosis/fibrosis in 34 (65%) and seminoma in 18 (35%). With a median (IQR) follow-up of 13 (2–48) months, 5 (10%) patients had disease recurrence, and one patient died of disease (Figure 1). The 1- and 2-year recurrence-free survivals were 92% and 88%, respectively. CONCLUSIONS: One third of patients with residual retroperitoneal mass following chemotherapy for testicular seminoma may have viable tumor. At centers with expertise in testicular cancer management, PC-RPLND is an appropriate option with favorable oncological outcomes. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e9 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Alireza Ghoreifi More articles by this author Christina Steinbach More articles by this author Farshad Sheybaee Moghaddam More articles by this author David Pfister More articles by this author Pia Paffenholz More articles by this author Axel Heidenreich More articles by this author Siamak Daneshmand More articles by this author Expand All Advertisement PDF downloadLoading ...