Mp01-19 Radiologic and Clinical Predictors of Concurrent Vascular Surgery in Post-Chemotherapy Retroperitoneal Lymph Node Dissection for Testicular Cancer

You have accessJournal of UrologyPenile & Testicular Cancer I (MP01)1 May 2024MP01-19 RADIOLOGIC AND CLINICAL PREDICTORS OF CONCURRENT VASCULAR SURGERY IN POST-CHEMOTHERAPY RETROPERITONEAL LYMPH NODE DISSECTION FOR TESTICULAR CANCER Farshad Sheybaee Moghaddam, Justin Lee, Sanam Ladi Seyedian, Alireza Ghoreifi, Sina Sobhani, Maria Lizana, Taseen Haque, Madeleine L. Burg, Ryan Lee, Anne Schuckman, Siamak Daneshmand, Nima Momenin, and Hooman Djaladat Farshad Sheybaee MoghaddamFarshad Sheybaee Moghaddam , Justin LeeJustin Lee , Sanam Ladi SeyedianSanam Ladi Seyedian , Alireza GhoreifiAlireza Ghoreifi , Sina SobhaniSina Sobhani , Maria LizanaMaria Lizana , Taseen HaqueTaseen Haque , Madeleine L. BurgMadeleine L. Burg , Ryan LeeRyan Lee , Anne SchuckmanAnne Schuckman , Siamak DaneshmandSiamak Daneshmand , Nima MomeninNima Momenin , and Hooman DjaladatHooman Djaladat View All Author Informationhttps://doi.org/10.1097/01.JU.0001008660.87408.90.19AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The success of post-chemotherapy retroperitoneal lymph node dissection (PC-RPLND) for testicular tumors depends on thorough resection of residual tumors, often requiring additional surgeries such as vascular procedures. We aimed to explore the radiologic and clinical parameters linked to vascular resection during PC-RPLND. METHODS: We retrospectively analyzed our IRB-approved testis cancer database, reviewing pre- and post-chemotherapy CT scans of patients who underwent PC-RPLND for testicular germ cell tumors from 2004 to 2022. We used neural network machine learning and multivariable analysis (MVA) to find independent predictors of vascular resection. RESULTS: Of 230 PC-RPLND patients, 48 (21%) had concurrent vascular procedures. Among 35 patients with available imaging, 26 had inferior vena cava (IVC) resection without graft placement. Of 30 patients with great vessel resection, four had aortic (11.4%), and three had both IVC and aortic resection (8.6%). Nine had metastatic mature teratoma; three had viable tumors in the resected vena cava, including a metastatic seminoma and two embryonal carcinomas. The recurrence rate was 16.7% in the great vessel resection group. Tables 1 and 2 show the baseline and the radiologic features, respectively. Figure 1 depicts the normalized significance of variables, emphasizing the impact of the pre-chemotherapy IVC diameter, craniocaudal size, and circumferential contact of the dominant mass with the IVC. On univariate analysis, pure non-seminoma, higher clinical stage, pre-chemotherapy inter-aortocaval mass, and IVC thrombosis in post-chemotherapy CT scan were associated with great vessel resection, but none were significant on MVA. CONCLUSIONS: IVC resection was the main concurrent vascular surgery in PC-RPLND. Machine learning identified potential predictors for additional vascular interventions, such as clinical stage, orchiectomy pathology, and IVC radiologic parameters. Larger studies are needed to validate this correlation. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e10 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Farshad Sheybaee Moghaddam More articles by this author Justin Lee More articles by this author Sanam Ladi Seyedian More articles by this author Alireza Ghoreifi More articles by this author Sina Sobhani More articles by this author Maria Lizana More articles by this author Taseen Haque More articles by this author Madeleine L. Burg More articles by this author Ryan Lee More articles by this author Anne Schuckman More articles by this author Siamak Daneshmand More articles by this author Nima Momenin More articles by this author Hooman Djaladat More articles by this author Expand All Advertisement PDF downloadLoading ...