postchemotherapy retroperitoneal lymph node dissection in patients with nonseminomatous testicular cancer: a single center experiences

Background: testicular cancer accounts for about 1 - 1.5% of all malignancies in men. radical orchiectomy is curative in 75% of patients with stage i disease, but advance stage with retroperitoneal lymph node involvement needs chemotherapy. all patients who have residual masses ≥ 1 cm after chemotherapy should undergo postchemotherapy retroperitoneal lymph node dissection (pc-rplnd). objectives: treatment of advanced nonseminomatous testicular cancer is usually a combination of chemotherapy and surgery. we described our experience about postchemotherapy retroperitoneal lymph node dissection (pc-rplnd) in our center. patients and methods: in a retrospective cross-sectional study between 2006 and 2011, patients with a history of postchemotherapy retroperitoneal lymph node dissection (pc-rplnd) in imam khomeini hospital were evaluated. all patients had normal postchemotherapy serum tumor markers and primary nonseminomatous cancer. we reviewed retrospectively clinical, pathological, and surgical parameters associated with pc-rplnd in our center.results: twenty-one patients underwent bilateral pc-rplnd. mean age was 26.3 years (ranged 16 - 47). mean size of retroperitoneal mass after chemotherapy was 7.6 cm. mean operative time was 198 minutes (120 - 246 minutes). mean follow-up time was 38.6 months. pathologic review showed presence of fibrosis/necrosis, viable germ cell tumor and teratoma in 8 (38.1%), 10 (47.6%) and 3 (14.28%) patients, respectively. one patient in postoperative period of surgery and three patients in two first years after surgery were expired. of 17 alive patients, only two (11.8%) had not retrograde ejaculation. conclusions: pc-rplnd is one the major operations in the field of urology, which is associated with significant adjunctive surgeries. in appropriate cases, pc-rplnd was associated with good cancer specific survival in tertiary oncology center.