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Retroperitoneal Lymph Node Dissection Versus Surveillance for Adult Early Stage Pure Testicular Teratoma: A Nationwide Analysis

  • Urologic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Purpose

Following radical orchiectomy, surveillance and primary retroperitoneal lymph node dissection (RPLND) are acceptable options for the management of early stage pure testicular teratoma in adult patients; however, there is no uniform consensus. The aim of this study was to investigate survival outcomes of adults with early stage pure testicular teratoma based on management strategy.

Methods

Data was extracted from the National Cancer Database (NCDB) from testicular cancer patients diagnosed with clinical stage (CS) I pure teratoma (pT1-4N0M0S0) between 2004 and 2014. Kaplan-Meier and Cox regression analyses were used to assess clinical outcomes based on management strategy.

Results

Of the 61,167 patients diagnosed with testicular cancer, 692 (1.1%) had pure teratoma. Only individuals with CS I disease were considered (n = 237). The median age was 28 (23–35) years. Overall, 43 (18%) patients underwent RPLND and 194 (82%) patients were managed with surveillance. There was an increase in surveillance for CS I teratoma during the study period. Increasing distance from residence to treatment facility was an unadjusted predictor for undergoing primary RPLND (p < 0.001). Median follow-up was 54 months and there was no significant difference in overall survival between CS I teratoma patients managed with RPLND and those managed with surveillance (p = 0.13).

Conclusions

There has been a trend toward increasing adoption of surveillance for the management of early stage pure testicular teratoma in adults. Our findings suggest that surveillance provides comparable survival outcomes to primary retroperitoneal lymph node dissection in this setting.

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Acknowledgment

The data used in the study are derived from a de-identified NCDB file. The American College of Surgeons and the Commission on Cancer have not verified and are not responsible for the analytic or statistical methodology employed, or the conclusions drawn from these data by the investigators.

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Authors and Affiliations

  1. Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA

    Ali Hajiran MD, Mounsif Azizi MD, Ahmet M. Aydin MD, Nicholas H. Chakiryan MD, Charles C. Peyton MD, Brandon J. Manley MD, Scott M. Gilbert MD & Wade J. Sexton MD

  2. Department of Biostatistics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA

    David C. Boulware PhD

  3. Department of Integrated Mathematical Oncology, H. Lee Moffitt Cancer Center and Research Institute Center, Tampa, FL, USA

    Brandon J. Manley MD

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  1. Ali Hajiran MD
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  2. Mounsif Azizi MD
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  3. Ahmet M. Aydin MD
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  9. Wade J. Sexton MD
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Correspondence to Ali Hajiran MD.

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Disclosure

All authors have no conflicts of interest to report regarding the data presented in this current study. All authors have read and approved this manuscript and it is not under consideration for publication elsewhere, nor has it previously been published. All authors have contributed to the information and material presented. No authors have direct or indirect commercial or financial incentives associated with the publication of this manuscript. No extra-institutional funding was required. The study was reviewed and approved by our institutional review board for ethics. We certify that the material in this assignment is our own work and not plagiarized.

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Hajiran, A., Azizi, M., Aydin, A.M. et al. Retroperitoneal Lymph Node Dissection Versus Surveillance for Adult Early Stage Pure Testicular Teratoma: A Nationwide Analysis. Ann Surg Oncol 28, 3648–3655 (2021). https://doi.org/10.1245/s10434-021-09696-3

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  • DOI: https://doi.org/10.1245/s10434-021-09696-3

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