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Robotic post-chemotherapy retroperitoneal lymph node dissection for testicular cancer: A multicenter collaborative study.
Ghoreifi, Alireza; Mitra, Anirban P; McClintock, George; Baky, Fady; McDowell, Zachary; Lavallée, Etienne; Saoud, Ragheed; Cai, Jie; Gill, Inderbir S; Sfakianos, John; Porter, James; Bagrodia, Aditya; Ahmadi, Nariman; Eggener, Scott; Ward, John F; Djaladat, Hooman.
Afiliación
  • Ghoreifi A; Institute of Urology, University of Southern California, Los Angeles, CA.
  • Mitra AP; Department of Urology and Department of Computational Biomedicine, Cedars-Sinai Medical Center, Los Angeles, CA.
  • McClintock G; Department of Urology, Chris O'Brien Lifehouse, Sydney, NSW, Australia.
  • Baky F; Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX.
  • McDowell Z; Swedish Urology Group, Seattle, WA.
  • Lavallée E; Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY.
  • Saoud R; Department of Surgery, Section of Urology, University of Chicago, Chicago, IL.
  • Cai J; Institute of Urology, University of Southern California, Los Angeles, CA.
  • Gill IS; Institute of Urology, University of Southern California, Los Angeles, CA.
  • Sfakianos J; Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY.
  • Porter J; Swedish Urology Group, Seattle, WA.
  • Bagrodia A; Department of Urology, UC San Diego School of Medicine, La Jolla, CA.
  • Ahmadi N; Department of Urology, Chris O'Brien Lifehouse, Sydney, NSW, Australia.
  • Eggener S; Department of Surgery, Section of Urology, University of Chicago, Chicago, IL.
  • Ward JF; Department of Urology, University of Texas MD Anderson Cancer Canter, Houston, TX.
  • Djaladat H; Institute of Urology, University of Southern California, Los Angeles, CA. Electronic address: djaladat@med.usc.edu.
Urol Oncol ; 41(2): 111.e7-111.e14, 2023 02.
Article en En | MEDLINE | ID: mdl-36437156
OBJECTIVES: To evaluate the perioperative and oncological/functional outcomes of robotic post-chemotherapy retroperitoneal lymph node dissection for testicular cancer. METHODS AND MATERIALS: In this retrospective study, we included patients who underwent robotic post-chemotherapy retroperitoneal lymph node dissection at 7 academic centers between 2011 and 2021. Patients' characteristics, perioperative findings, as well as oncological and functional outcomes are reviewed. Relationships with the main outcome (90-day complications) were analyzed using multivariable logistic regression. RESULTS: A total of 90 patients with a median (IQR) age of 30 (25-37) years were included. The main primary histologic type was non-seminomatous germ cell tumor (89%). Seven patients (8%) were electively converted to open. Median estimated blood loss, operative time, and length of hospital stay were 150 ml, 5.6 hours, and 2 days, respectively. Final pathology revealed teratoma in 49 (55%), necrosis/fibrosis in 29 (32%), and viable germ cell tumor in 12 (13%) patients. The 90-day complication rate was 16.7%, most of which were low-grade (Clavien-Dindo < III) and managed conservatively. On multivariable analysis, pure seminoma (odds ratio 17.4) and bilateral dissection template (odds ratio 4.2) were independently associated with 90-day complications. No 90-day hospital readmission was recorded. With a median (IQR) follow-up of 16 (4-32) months, 6 (6.7%) patients had disease recurrence and there was 1 cancer-related death. CONCLUSION: With appropriate patient selection at centers with expertise in testicular cancer and minimally invasive surgery, robotic post-chemotherapy retroperitoneal lymph node dissection appears safe and effective, although longer follow-up is warranted.
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Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Neoplasias Testiculares / Neoplasias de Células Germinales y Embrionarias / Procedimientos Quirúrgicos Robotizados Tipo de estudio: Clinical_trials / Observational_studies / Risk_factors_studies Límite: Adult / Humans / Male Idioma: En Revista: Urol Oncol Asunto de la revista: NEOPLASIAS / UROLOGIA Año: 2023 Tipo del documento: Article

Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Neoplasias Testiculares / Neoplasias de Células Germinales y Embrionarias / Procedimientos Quirúrgicos Robotizados Tipo de estudio: Clinical_trials / Observational_studies / Risk_factors_studies Límite: Adult / Humans / Male Idioma: En Revista: Urol Oncol Asunto de la revista: NEOPLASIAS / UROLOGIA Año: 2023 Tipo del documento: Article