EN BLOC NEPHRECTOMY IN PATIENTS UNDERGOING POST-CHEMOTHERAPY RETROPERITONEAL LYMPH NODE DISSECTION FOR NONSEMINOMATOUS TESTIS CANCER: INDICATIONS, IMPLICATIONS AND OUTCOMES

Abstract

No AccessJournal of UrologyClinical Urology: Original Articles1 Mar 1998EN BLOC NEPHRECTOMY IN PATIENTS UNDERGOING POST-CHEMOTHERAPY RETROPERITONEAL LYMPH NODE DISSECTION FOR NONSEMINOMATOUS TESTIS CANCER: INDICATIONS, IMPLICATIONS AND OUTCOMES PETER A. NASH, ILAN LEIBOVITCH, RICHARD S. FOSTER, RICHARD BIHRLE, RANDALL G. ROWLAND, and JOHN P. DONOHUE PETER A. NASHPETER A. NASH , ILAN LEIBOVITCHILAN LEIBOVITCH , RICHARD S. FOSTERRICHARD S. FOSTER , RICHARD BIHRLERICHARD BIHRLE , RANDALL G. ROWLANDRANDALL G. ROWLAND , and JOHN P. DONOHUEJOHN P. DONOHUE View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)63706-6AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We review the indications for nephrectomy at post-chemotherapy retroperitoneal lymph node dissection, identify patients at risk for nephrectomy and assess the impact of nephrectomy on outcome. Materials and Methods: Using a computerized data base and chart review we retrospectively reviewed the records of 848 patients who underwent retroperitoneal lymph node dissection after chemotherapy. Results: En bloc nephrectomy was performed at retroperitoneal lymph node dissection after chemotherapy in 162 of the 848 patients (19%). The indications for nephrectomy included contiguous involvement of perirenal structures in 73% of the cases, renal vein thrombosis in 6%, a poorly functioning or nonfunctioning renal unit in 5% and a combination of these conditions in 16%. Pathological studies of the hilum revealed cancer in 20% of the cases, teratoma in 49% and fibrosis in 31%. Patients requiring nephrectomy had significantly more advanced disease and larger disease volume at presentation and after chemotherapy. There were no significant differences in perioperative morbidity or mortality compared with patients who did not undergo nephrectomy. Only 3 patients required perioperative dialysis and none required long-term renal support. Conclusions: These findings support en bloc nephrectomy at post-chemotherapy retroperitoneal lymph node dissection in select patients with large volume perihilar retroperitoneal disease. References 1 : Complications of retroperitoneal lymphadenectomy. Urology1979; 13: 241. Google Scholar 2 : Complications of retroperitoneal lymph node dissection. J. Urol.1981; 125: 338. Link, Google Scholar 3 : Complications of thoracoabdominal retroperitoneal lymph node dissection. J. Urol.1982; 127: 1107. Link, Google Scholar 4 : Early and late complications of retroperitoneal lymphadenectomy in testis cancer. Canad. J. Surg.1991; 34: 368. Google Scholar 5 : Complications of post-chemotherapy retroperitoneal lymph node dissection. J. Urol.1995; 153: 976. Link, Google Scholar From the Department of Urology, Indiana University Medical Center, Indianapolis, Indiana.© 1998 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byCary K, Beck S, Bihrle R and Foster R (2012) Clinical and Pathological Features Predictive of Nephrectomy at Post-Chemotherapy Retroperitoneal Lymph Node DissectionJournal of Urology, VOL. 189, NO. 3, (812-817), Online publication date: 1-Mar-2013.Stephenson A, Tal R and Sheinfeld J (2018) Adjunctive Nephrectomy at Post-Chemotherapy Retroperitoneal Lymph Node Dissection for Nonseminomatous Germ Cell Testicular CancerJournal of Urology, VOL. 176, NO. 5, (1996-1999), Online publication date: 1-Nov-2006.MOSHARAFA A, FOSTER R, KOCH M, BIHRLE R and DONOHUE J (2018) Complications of Post-Chemotherapy Retroperitoneal Lymph Node Dissection for Testis CancerJournal of Urology, VOL. 171, NO. 5, (1839-1841), Online publication date: 1-May-2004. Volume 159Issue 3March 1998Page: 707-710 Advertisement Copyright & Permissions© 1998 by American Urological Association, Inc.MetricsAuthor Information PETER A. NASH More articles by this author ILAN LEIBOVITCH More articles by this author RICHARD S. FOSTER More articles by this author RICHARD BIHRLE More articles by this author RANDALL G. ROWLAND More articles by this author JOHN P. DONOHUE More articles by this author Expand All Advertisement PDF downloadLoading ...