Surgical removal of lymph nodes in advanced testicular cancer: A review

What is it about?

This systematic review assessed primary retroperitoneal lymph node dissection (RPLND) for stage II testicular seminoma. RPLND demonstrated good peri-operative outcomes when performed by experienced surgeons but had higher recurrence rates compared to standard treatments. The review highlights the need for long-term survival data to better evaluate this approach.

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Why is it important?

This research is important because it systematically reviews the current role of primary retroperitoneal lymph node dissection (RPLND) in stage II testicular seminoma. Given that testicular cancer is the most common solid tumor in young men, understanding alternative treatment options to standard radiotherapy and chemotherapy is crucial. RPLND could potentially offer a surgical alternative that may reduce long-term toxicities associated with current treatments, which is especially significant for younger patients concerned about fertility, cardiovascular health, and risk of secondary malignancies. This study provides valuable insights into the oncological outcomes, functional results, and perioperative safety of RPLND in this patient population. Key Takeaways: 1. Treatment Alternative: RPLND performed by experienced surgeons shows good perioperative outcomes and may offer an alternative to standard radiotherapy or chemotherapy for stage II testicular seminoma, potentially reducing long-term toxicities. 2. Recurrence Patterns: While recurrence rates with RPLND appear higher than standard treatments, most recurrences (78%) occur outside the RPLND field, suggesting the need for careful patient selection and follow-up. 3. Limited Long-term Data: The review highlights a lack of long-term survival and functional data for RPLND in this context, emphasizing the need for further research to fully evaluate its efficacy and safety compared to standard treatments.