Nerve‐sparing retroperitoneal lymph node dissection for advanced testicular cancer after chemotherapy
Identifieur interne : 000F49 ( Istex/Curation ); précédent : 000F48; suivant : 000F50Nerve‐sparing retroperitoneal lymph node dissection for advanced testicular cancer after chemotherapy
Auteurs : Norio Nonomura [Japon] ; Kazuo Nishimura ; Natsuki Takaha ; Hitoshi Inoue ; Takeshi Nomoto [Japon] ; Youichi Mizutani [Japon] ; Masahiro Nakao [Japon] ; Akihiko Okuyama ; Tsuneharu Miki [Japon]Source :
- International Journal of Urology [ 0919-8172 ] ; 2002-10.
English descriptors
- Teeft :
- Antegrade ejaculation, Bhcg, Cancer control, Chemotherapy, Cisplatinum, Dissection, Early stage testicular germ cell tumors, Ejaculation, Ejaculatory, Ejaculatory function, Etoposide, Iiib2, Immature teratoma, Liver metastases, Lumbar, Lumbar splanchnic nerves, Lymph, Metastatic, Metastatic testicular cancer, Node, Normal ejaculation, Postchemotherapy, Postchemotherapy rplnd, Primary chemotherapy, Recurrence, Residual, Retroperitoneal, Retroperitoneal lymph node dissection, Retroperitoneal lymphadenectomy, Retroperitoneal masses, Retroperitoneal recurrence, Rpln, Rplnd, Splanchnic, Superior hypogastric plexus, Teratoma, Testicular, Testicular cancer, Urol, Viable cancer cells.
Abstract
Background: Nerve‐sparing techniques are commonly used in retroperitoneal lymph node dissection (RPLND) in patients with early stage testicular germ cell tumors to preserve postoperative ejaculation. The indications for nerve‐sparing procedures have been extended to patients who have residual retroperitoneal tumor postchemotherapy with an increase in the incidence of local recurrence. Here, we report on 26 Japanese men with advanced testicular cancer who underwent nerve‐sparing RPLND after partially successful chemotherapy.
Methods: Between January 1995 and December 2000, 26 patients with metastatic or recurrent testicular cancer underwent nerve‐sparing RPLND after chemotherapy. Eight patients had seminoma and 18 had non‐seminoma. Three patients received high‐dose chemotherapy with carboplatin (250 mg/m2 per day × 5 days), etoposide (300 mg/m2 per day × 5 days) and ifosfamide (1.5 g/m2 per day × 5 days) in combination with peripheral blood stem cell transplantation.
Results: In all cases, lumbar splanchnic nerves were preserved macroscopically during the operation, at least unilaterally. Twenty‐two patients (84.6%) achieved antegrade ejaculation during a mean follow‐up at 3.9 months (range: 1–7 months). Three patients have fathered children. Only one patient suffered a retroperitoneal recurrence during a median follow‐up at 25.8 months (range: 6–76 months).
Conclusion: Nerve‐sparing procedures for RPLND are appropriate for patients with metastatic testicular cancer, even after chemotherapy. The procedure preserves ejaculatory function in the majority of the patients without increasing the risk of local recurrence. Nerve‐sparing RPLND improves the quality of life in patients who require postchemotherapy RPLND to treat residual tumor.
Url:
DOI: 10.1046/j.1442-2042.2002.00520.x
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Kazuo Nishimura<affiliation><mods:affiliation>Department of Specific Organ Regulation (Urology), Osaka University Graduate School of Medicine, Suita and</mods:affiliation><wicri:noCountry code="subField">and</wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Specific Organ Regulation (Urology), Osaka University Graduate School of Medicine, Suita and</mods:affiliation><wicri:noCountry code="subField">and</wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Specific Organ Regulation (Urology), Osaka University Graduate School of Medicine, Suita and</mods:affiliation><wicri:noCountry code="subField">and</wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Specific Organ Regulation (Urology), Osaka University Graduate School of Medicine, Suita and</mods:affiliation><wicri:noCountry code="subField">and</wicri:noCountry></affiliation>Le document en format XML
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Graduate School of Medicine, Suita and</mods:affiliation></affiliation><affiliation wicri:level="1"><mods:affiliation>E-mail: nono@uro.med.osaka‐u.ac.jp</mods:affiliation><country wicri:rule="url">Japon</country></affiliation></author><author><name sortKey="Nishimura, Kazuo" sort="Nishimura, Kazuo" uniqKey="Nishimura K" first="Kazuo" last="Nishimura">Kazuo Nishimura</name><affiliation><mods:affiliation>Department of Specific Organ Regulation (Urology), Osaka University Graduate School of Medicine, Suita and</mods:affiliation><wicri:noCountry code="subField">and</wicri:noCountry></affiliation></author><author><name sortKey="Takaha, Natsuki" sort="Takaha, Natsuki" uniqKey="Takaha N" first="Natsuki" last="Takaha">Natsuki Takaha</name><affiliation><mods:affiliation>Department of Specific Organ Regulation (Urology), Osaka University Graduate School of Medicine, Suita and</mods:affiliation><wicri:noCountry code="subField">and</wicri:noCountry></affiliation></author><author><name sortKey="Inoue, Hitoshi" sort="Inoue, Hitoshi" uniqKey="Inoue H" first="Hitoshi" last="Inoue">Hitoshi Inoue</name><affiliation><mods:affiliation>Department of Specific Organ Regulation (Urology), Osaka University Graduate School of Medicine, Suita and</mods:affiliation><wicri:noCountry code="subField">and</wicri:noCountry></affiliation></author><author><name sortKey="Nomoto, Takeshi" sort="Nomoto, Takeshi" uniqKey="Nomoto T" first="Takeshi" last="Nomoto">Takeshi Nomoto</name><affiliation wicri:level="1"><mods:affiliation>Department of Urology, Kyoto Prefectural University of Medicine, Kyoto, Japan</mods:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Urology, Kyoto Prefectural University of Medicine, Kyoto</wicri:regionArea></affiliation></author><author><name sortKey="Mizutani, Youichi" sort="Mizutani, Youichi" uniqKey="Mizutani Y" first="Youichi" last="Mizutani">Youichi Mizutani</name><affiliation wicri:level="1"><mods:affiliation>Department of Urology, Kyoto Prefectural University of Medicine, Kyoto, Japan</mods:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Urology, Kyoto Prefectural University of Medicine, Kyoto</wicri:regionArea></affiliation></author><author><name sortKey="Nakao, Masahiro" sort="Nakao, Masahiro" uniqKey="Nakao M" first="Masahiro" last="Nakao">Masahiro Nakao</name><affiliation wicri:level="1"><mods:affiliation>Department of Urology, Kyoto Prefectural University of Medicine, Kyoto, Japan</mods:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Urology, Kyoto Prefectural University of Medicine, Kyoto</wicri:regionArea></affiliation></author><author><name sortKey="Okuyama, Akihiko" sort="Okuyama, Akihiko" uniqKey="Okuyama A" first="Akihiko" last="Okuyama">Akihiko Okuyama</name><affiliation><mods:affiliation>Department of Specific Organ Regulation (Urology), Osaka University Graduate School of Medicine, Suita and</mods:affiliation><wicri:noCountry code="subField">and</wicri:noCountry></affiliation></author><author><name sortKey="Miki, Tsuneharu" sort="Miki, Tsuneharu" uniqKey="Miki T" first="Tsuneharu" last="Miki">Tsuneharu Miki</name><affiliation wicri:level="1"><mods:affiliation>Department of Urology, Kyoto Prefectural University of Medicine, Kyoto, Japan</mods:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Urology, Kyoto Prefectural University of Medicine, Kyoto</wicri:regionArea></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">International Journal of Urology</title><title level="j" type="alt">INTERNATIONAL JOURNAL OF UROLOGY</title><idno type="ISSN">0919-8172</idno><idno type="eISSN">1442-2042</idno><imprint><biblScope unit="vol">9</biblScope><biblScope unit="issue">10</biblScope><biblScope unit="page" from="539">539</biblScope><biblScope unit="page" to="544">544</biblScope><biblScope unit="page-count">6</biblScope><publisher>Blackwell Science Pty</publisher><pubPlace>Melbourne, Australia</pubPlace><date type="published" when="2002-10">2002-10</date></imprint><idno type="ISSN">0919-8172</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0919-8172</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="Teeft" xml:lang="en"><term>Antegrade ejaculation</term><term>Bhcg</term><term>Cancer control</term><term>Chemotherapy</term><term>Cisplatinum</term><term>Dissection</term><term>Early stage testicular germ cell tumors</term><term>Ejaculation</term><term>Ejaculatory</term><term>Ejaculatory function</term><term>Etoposide</term><term>Iiib2</term><term>Immature teratoma</term><term>Liver metastases</term><term>Lumbar</term><term>Lumbar splanchnic nerves</term><term>Lymph</term><term>Metastatic</term><term>Metastatic testicular cancer</term><term>Node</term><term>Normal ejaculation</term><term>Postchemotherapy</term><term>Postchemotherapy rplnd</term><term>Primary chemotherapy</term><term>Recurrence</term><term>Residual</term><term>Retroperitoneal</term><term>Retroperitoneal lymph node dissection</term><term>Retroperitoneal lymphadenectomy</term><term>Retroperitoneal masses</term><term>Retroperitoneal recurrence</term><term>Rpln</term><term>Rplnd</term><term>Splanchnic</term><term>Superior hypogastric plexus</term><term>Teratoma</term><term>Testicular</term><term>Testicular cancer</term><term>Urol</term><term>Viable cancer cells</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract">Background: Nerve‐sparing techniques are commonly used in retroperitoneal lymph node dissection (RPLND) in patients with early stage testicular germ cell tumors to preserve postoperative ejaculation. The indications for nerve‐sparing procedures have been extended to patients who have residual retroperitoneal tumor postchemotherapy with an increase in the incidence of local recurrence. Here, we report on 26 Japanese men with advanced testicular cancer who underwent nerve‐sparing RPLND after partially successful chemotherapy.</div><div type="abstract">Methods: Between January 1995 and December 2000, 26 patients with metastatic or recurrent testicular cancer underwent nerve‐sparing RPLND after chemotherapy. Eight patients had seminoma and 18 had non‐seminoma. Three patients received high‐dose chemotherapy with carboplatin (250 mg/m2 per day × 5 days), etoposide (300 mg/m2 per day × 5 days) and ifosfamide (1.5 g/m2 per day × 5 days) in combination with peripheral blood stem cell transplantation.</div><div type="abstract">Results: In all cases, lumbar splanchnic nerves were preserved macroscopically during the operation, at least unilaterally. Twenty‐two patients (84.6%) achieved antegrade ejaculation during a mean follow‐up at 3.9 months (range: 1–7 months). Three patients have fathered children. Only one patient suffered a retroperitoneal recurrence during a median follow‐up at 25.8 months (range: 6–76 months).</div><div type="abstract">Conclusion: Nerve‐sparing procedures for RPLND are appropriate for patients with metastatic testicular cancer, even after chemotherapy. The procedure preserves ejaculatory function in the majority of the patients without increasing the risk of local recurrence. Nerve‐sparing RPLND improves the quality of life in patients who require postchemotherapy RPLND to treat residual tumor.</div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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