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Diagnostic and Therapeutic Laparoscopic Retroperitoneal Lymph Node Dissection in Low-Stage Nonseminomatous GCC: The European View

  • Günter JanetschekEmail author
  • Reinhold P. Zimmermann
Chapter

Abstract

Retroperitoneal lymph node dissection has a role in the staging and treatment of low stages nonseminomatous germ cell testicular cancer. Laparoscopic retroperitoneal lymph node dissection (LRPLND) mimics the open counterpart. However, concept and indications for LRPLND differ to some extent between Europe and US. In this chapter the European standpoint is discussed.The goal of diagnostic LRPLND is the removal of primary landing sites following the Weissbach and Boedefeld templates. In clinical stage II the goal of LRPLND is to reduce the number of cycles of chemotherapy and consequently its morbidity. In Stage II, the same templates are advised, although previous chemotherapy and extent of disease rend tissue identification more difficult than in stage I. Results of European series on clinical stage I/pathological stage II and pathological stage II after chemotherapy are discussed.

Keywords

Mature Teratoma Chylous Ascites Nonseminomatous Germ Cell Retroperitoneal Lymph Node Dissection Nonseminomatous Germ Cell Tumor 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. Albers P, Albrecht W, Algaba F, Bokemeyer C, Cohn-Cedermark G, Horvich A et al (2009) EAU Working group on Testis Cancer. EAU guidelines on testicular cancer. In EAU-guidelines edition pp 1–46Google Scholar
  2. Donohue JP, Thornhill JA, Foster RS et al (1995) The role of retroperitoneal lymphadenectomy in clinical stage B testis cancer: The Indiana University experience (1965 to 1989). J Urol 153:85–89PubMedCrossRefGoogle Scholar
  3. Holtl L, Peschel R, Knapp R, Janetschek G (2002) Primary lymphatic metastatic spread in testicular cancer occurs ventral to the lumbar vessels. Urol 59:114–118PubMedCrossRefGoogle Scholar
  4. Janetschek G, Hobisch A, Höltl L et al (1996) Retroperitoneal lymphadenectomy for clinical stage I nonseminomatous testicular tumor: Laparoscopy versus open surgery and impact of Iearning curve. J Urol 156:89–93PubMedCrossRefGoogle Scholar
  5. Javadpour N (1984) Predictors of recurrence in stage II non seminomatous testicular cancer after lymphadenectomy: Implications for adjuvant chemotherapy. J Urol 135:629Google Scholar
  6. Pizzocaro G, Nicolai N, Salvioni R (1994) Evolution and controversies in the management of Iow- stage nonsemi nomatous germ-cell tumors of the testis. World J. Urol 12:113–119Google Scholar
  7. Richie JP, Kantoff PW (1991) Is adjuvant chemotherapy necessary for patients with stage I testicular cancer? J Clin Oncol 9:1393–1396PubMedGoogle Scholar
  8. Weissbach L, Boedefeld EA (1987) Testicular Tumor Study Group: Localization of solitary and multiple metastases in stage II nonseminomatous testis tumor as basis for a modified staging lymph node dissection in stage I. J Urol 138:77–82PubMedGoogle Scholar
  9. Williams SD, Stablein DM, Einhorn LH, Muggia FM, Weiss RB, Donohue JP et al (1987) Immediate adjuvant chemotherapy versus observation with treatment at relapse in pathological stage II testicular cancer. N Engl J Med 317:1433–1438PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London Limited 2011

Authors and Affiliations

  1. 1.Department of UrologyParacelsus Medical UniversitySalzburgAustria

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