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Management of residual masses in testicular germ cell tumors |
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| Authors: | Axel Heidenreich Pia Paffenholz Tim Nestler David Pfister |
| Institution: | 1. Department of Urology, Urologic Oncology, Robot-assisted and Specialized Urologic Surgery, University Hospital Cologne, K?ln, Germanyaxel.heidenreich@uk-koeln.de;3. Department of Urology, Urologic Oncology, Robot-assisted and Specialized Urologic Surgery, University Hospital Cologne, K?ln, Germany |
| Abstract: | Introduction: About 50% of all patients with advanced testicular cancer demonstrate residual retroperitoneal or extraretroperitoneal masses. About two thirds of the masses harbour necrosis/fibrosis only whereas as about 10% and 40% harbour vital cancer or teratoma. Appropriate therapy will result in a high cure rate if performed properly. Areas covered: This review article covers the indication, the surgical technique and the oncological outcome of PC-RPLND and resection of extraretroperitoneal residual masses following chemotherapy in patients with advanced testis cancer. Expert commentary: Postchemotherapy retroperitoneal lymph node dissection (PC-RPLND) plays an integral part of the multimodality treatment in patients with advanced testicular germ cell tumours. Patients with nonseminomas, residual masses < 1cm and good prognosis can undergo active surveillance. In all other cases, PC-RPLND with or without resection of adjacent organs needs to be performed for curative intent. PC-RPLND requires a complex surgical approach and should be performed in experienced, tertiary referral centres only. |
| Keywords: | Testis cancer chemotherapy metastases nonseminomas seminoma mature teratoma nerve-sparing surgery |