The role of retroperitoneal lymphadenectomy in patients with testicular non-seminomatous germ cell tumors and ejaculatory dysfunction
Authors:
MUDr. Jaroslav Jarabák 1; Doc. MUDr. Roman Zachoval, Ph.D. 1; Prof. MUDr. Jitka Abrahámová, DrSc. 2; MUDr. Zuzana Donátová 2
Authors‘ workplace:
Urologické oddělení, Fakultní Thomayerova nemocnice s poliklinikou
1; Onkologické oddělení, Fakultní Thomayerova nemocnice s poliklinikou
2
Published in:
Urol List 2008; 6(4): 65-69
Overview
Multimodal approach including the combination of surveillance, chemotherapy and RPLA plays a key role in the management of NSGCT. In the last two decades RPLA has lost its originally dominant role in the management of early stage NSGCT in consequence of associated high morbidity, its negative impact on ejaculatory function and significant development in chemotherapy. With the development of laparoscopic techniques the modified and nerves-sparing form of RPLA is again becoming popular. In adequately chosen population of patients these techniques can achieve oncological results comparable with classical retroperitoneal lymphadenectomy, with low complication rate including ejaculatory dysfunction. Technically challenging salvage lymphadenectomy, which makes nerves-sparing techniques difficult, still plays a key role in the management of advanced NSGCT.
Key words:
retroperitoneal lymphadenectomy, ejaculatory function, nonseminomatous germ cell tumors
Sources
1. Jewett MA, Kang Y, Goldberg SD et.al. Retroperitoneal lymphadenectomy for testis tumor with nerve sparing for ejaculation. J Urol 1988; 139: 1220– 1224.
2. Donohue JP, Foster RS, Rowland RG et al. Nerve-sparing retroperitoneal lymphadenectomy with preservativ of ejaculation. J Urol 1993; 144: 287–292.
3. Pizzocaro G. Retroperitoneal lymphadenectomy in clinical stage I nonseminomatous germinal testis cancer. Eur J Surg Oncol 1986; 12: 25–28.
4. Foster RS. Modified retroperitoneal lymphadenectomy. BJU Int 2004; 94: 941–955.
5. Arruda HO, Paula AAP, Suarez R et al. Can selective retroperitoneal lymphadenectomy be better than unilateral retroperitoneal lymphadenectomy? Inter Braz J Urol 2003; 29: 412–417.
6. Magelssen H, Brydoy M, Fossa DS. The effects of cancer and cancer treatments on male reproductive function. Nat Clin Pract Urol 2006; 3(6): 312–322.
7. Fossa SD, Kleep O, Ous S et al. Unilateral retroperitoneal lymph node dissection in patiens with nonseminomatous testicular tumor in clinical stage I. Eur Urol 1984; 10: 17–23.
8. Klein EA. Open technique for nerve-sparing retroperitoneal lymphadenectomy. Urology 2000; 55: 132–135.
9. Baniel J, Foster RS, Rowland RG et al. Complications of primary retroperitoneal lymph node dissection. J Urol 1994; 152: 424–427.
10. Janetschek G, Hobish A, Hotl L et al. Retroperitoneal lymphadenectomy for clinical stage I nonseminomatous testicular tumor: laparoscopy versus oper surgery and impact of learning curve. J Urol 1996; 156(1): 89–93.
11. Argirovic D, Hadzi-Djokic J, Micic S. Quality of life after retroperitoneal lymphadenectomy in low clinical stages of nonseminomatous testicular tumors. Acta Chir Iugosl 1999; 46(1): 31–33.
12. Castelli E, Terrone C, De Lucca S et al. Retroperitoneal lymphadenectomy for testicular cancer and genito-sexual conditions: retrospective study. Prog Urol 2000; 10(4): 578–582.
13. Heidenreich A, Albers P, Hartmann M et al. Complications of primary nerve sparing retroperitoneal lymph node dissection for clinical stage I nonseminomatous germ cell tumors of the testis: experience of the german testicular cancer study group. J Urol 2003; 169: 1710–1714.
14. Castillo AO, Alvarez MJ, Vitagliano G et al. Linfadenectomia retroperitoneal laparoscopica en cancer de testiculo no seminoma estadio I. Arch Esp Urol 2007; 60(1): 59–66.
Labels
Paediatric urologist UrologyArticle was published in
Urological Journal
2008 Issue 4
Most read in this issue
- Male pelvic pain syndromes and sexual dysfunction
- Priapism
- Peyronie´s disease
- Osteopenia and osteoporosis in young men presenting with infertility or sexual dysfunction - clinical experience