Laparoscopic Retroperitoneal Lymph Node Dissection with Therapeutic Intent in Men with Clinical Stage I Nonseminomatous Germ Cell Tumors

2010 ◽  
Vol 24 (11) ◽  
pp. 1759-1763 ◽  
Author(s):  
Thomas J. Guzzo ◽  
Mark L. Gonzalgo ◽  
Mohamad E. Allaf
Keyword(s):  
Lymph Node ◽  
Germ Cell ◽  
Lymph Node Dissection ◽  
Clinical Stage ◽  
Germ Cell Tumors ◽  
Stage I ◽  
Retroperitoneal Lymph Node Dissection ◽  
Node Dissection ◽  
Retroperitoneal Lymph Node ◽  
Nonseminomatous Germ Cell Tumors

Comparison of surveillance and retroperitoneal lymph node dissection in Stage I nonseminomatous germ cell tumors

Urology ◽  
2002 ◽  
Vol 59 (6) ◽  
pp. 923-929 ◽  
Author(s):  
J.R Spermon ◽  
T.A Roeleveld ◽  
H.G van der Poel ◽  
C.A Hulsbergen-van de Kaa ◽  
W.W Ten Bokkel Huinink ◽  
...  
Keyword(s):  
Lymph Node ◽  
Germ Cell ◽  
Lymph Node Dissection ◽  
Germ Cell Tumors ◽  
Stage I ◽  
Retroperitoneal Lymph Node Dissection ◽  
Node Dissection ◽  
Retroperitoneal Lymph Node ◽  
Nonseminomatous Germ Cell Tumors

Randomized Phase III Trial Comparing Retroperitoneal Lymph Node Dissection With One Course of Bleomycin and Etoposide Plus Cisplatin Chemotherapy in the Adjuvant Treatment of Clinical Stage I Nonseminomatous Testicular Germ Cell Tumors: AUO Trial AH 01/94 by the German Testicular Cancer Study Group

2008 ◽  
Vol 26 (18) ◽  
pp. 2966-2972 ◽  
Author(s):  
Peter Albers ◽  
Roswitha Siener ◽  
Susanne Krege ◽  
Hans-Uwe Schmelz ◽  
Klaus-Peter Dieckmann ◽  
...  
Keyword(s):  
Lymph Node ◽  
Germ Cell ◽  
Lymph Node Dissection ◽  
Adjuvant Treatment ◽  
Clinical Stage ◽  
Germ Cell Tumors ◽  
Stage I ◽  
Retroperitoneal Lymph Node Dissection ◽  
Node Dissection ◽  
Retroperitoneal Lymph Node

PurposeRetroperitoneal lymph node dissection (RPLND) and adjuvant chemotherapy are two adjuvant treatment options for patients with clinical stage I nonseminomatous germ cell tumors of the testis (NSGCT). Aim of this trial was to prove the advantage of one cycle of bleomycin, etoposide, and cisplatin (BEP) chemotherapy compared with RPLND in terms of recurrence.Patients and MethodsBetween 1996 and 2005, 382 patients were randomly assigned to receive either RPLND (n = 191) or one course of BEP (n = 191) after orchidectomy. The primary study end point was the rate of recurrence. The trial was powered to detect a 7% reduction (from 10% to 3%) of recurrence with chemotherapy compared with surgery.ResultsAfter a median follow-up of 4.7 years, two and 15 recurrences were observed in the intention-to-treat population with chemotherapy and surgery, respectively (P = .0011). The difference in the 2-year recurrence-free survival rate between chemotherapy (99.46%; 95% CI, 96.20% to 99.92%) and surgery (91.87%; 95% CI, 86.87% to 95.02%) was 7.59% (95% CI, 3.13% to 12.05%). The hazard ratio to experience a tumor recurrence with surgery as opposed to chemotherapy was 7.937 (95% CI, 1.808 to 34.48).ConclusionTo our knowledge, this is the largest randomized trial investigating adjuvant treatment strategies in clinical stage I NSGCT, which showed the superiority of one course BEP over RPLND performed according to community standards to prevent recurrence. Although not standard treatment, one course of BEP is active in an unselected group of patients with clinical stage I disease and merits further investigation.

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