Surgical and oncologic outcomes of surgery in early metastatic seminoma: Multi-institutional retrospective study

You have accessJournal of UrologyCME1 Apr 2023MP33-18 SURGICAL AND ONCOLOGIC OUTCOMES OF SURGERY IN EARLY METASTATIC SEMINOMA: MULTI-INSTITUTIONAL RETROSPECTIVE STUDY Sanam Ladi-Seyedian, Muhannad Alsyouf, Brian Hu, Clint Cary, Timothy Masterson, Lawrence Einhorn, Nabil Adra, Stephen A. Boorjian, Christian Kollmannsberger, Anne Schuckman, Alan So, Peter Black, Aditya Bagrodia, Eila Skinner, Mehrdad Alemozaffar, Timothy Brand, Scott Eggener, Phillip Pierorazio, Kelly Stratton, Lucia Nappi, Craig Nichols, Axel Heidenreich, and Siamak Daneshmand Sanam Ladi-SeyedianSanam Ladi-Seyedian More articles by this author , Muhannad AlsyoufMuhannad Alsyouf More articles by this author , Brian HuBrian Hu More articles by this author , Clint CaryClint Cary More articles by this author , Timothy MastersonTimothy Masterson More articles by this author , Lawrence EinhornLawrence Einhorn More articles by this author , Nabil AdraNabil Adra More articles by this author , Stephen A. BoorjianStephen A. Boorjian More articles by this author , Christian KollmannsbergerChristian Kollmannsberger More articles by this author , Anne SchuckmanAnne Schuckman More articles by this author , Alan SoAlan So More articles by this author , Peter BlackPeter Black More articles by this author , Aditya BagrodiaAditya Bagrodia More articles by this author , Eila SkinnerEila Skinner More articles by this author , Mehrdad AlemozaffarMehrdad Alemozaffar More articles by this author , Timothy BrandTimothy Brand More articles by this author , Scott EggenerScott Eggener More articles by this author , Phillip PierorazioPhillip Pierorazio More articles by this author , Kelly StrattonKelly Stratton More articles by this author , Lucia NappiLucia Nappi More articles by this author , Craig NicholsCraig Nichols More articles by this author , Axel HeidenreichAxel Heidenreich More articles by this author , and Siamak DaneshmandSiamak Daneshmand More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003266.18AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The long-term toxicities of chemotherapy and radiotherapy can represent a significant burden to testicular cancer survivors. Although retroperitoneal lymph node dissection (RPLND) is an established treatment for testicular germ cell tumors, little data exists on its efficacy as a front-line treatment in early metastatic (stage II) seminoma. This study aims to assess the surgical and oncologic outcomes of RPLND as the primary treatment of stage II seminoma using multi-institutional dataset. METHODS: In this retrospective study, we included adult patients with Stage II testicular seminoma who underwent RPLND as the first-line treatment for their early metastatic disease. Patients’ characteristics, perioperative findings, and recurrence data were reviewed from 12 institutions in the North America and 1 site in Europe. RESULTS: A total of 94 patients with a median age of 35 (IQR 31 – 43) were enrolled with retroperitoneal lymphadenopathy between 1 - 5 cm. Two cases were performed robotically. An average of 23 (IQR 16 – 37) lymph nodes were removed. Pathologic upstaging occurred in 30% of patients. Of the 94 enrolled patients,11% were pN0, 30% pN1, 56% pN2, and 3% pN3. Overall, the recurrence free survival at 3 years was 82% and overall survival was 100%. Patient with pN2-3 showed significantly worse recurrence free survival than pN1 disease (78.5% versus 92%; P=0.04) (Figure 1). shows the surgical and postoperative outcomes of the cohort stratified by pathologic staging. In total, 7 (7.5%) patients experienced post-operative complications including ileus, incision ulceration, pulmonary embolism and chylous ascites. CONCLUSIONS: The finding of this retrospective multi-institutional study establishes RPLND as a viable option for first-line treatment of testicular seminoma with clinically low-volume retroperitoneal lymphadenopathy. It is associated with a low complication rate and high recurrence-free survival. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e457 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sanam Ladi-Seyedian More articles by this author Muhannad Alsyouf More articles by this author Brian Hu More articles by this author Clint Cary More articles by this author Timothy Masterson More articles by this author Lawrence Einhorn More articles by this author Nabil Adra More articles by this author Stephen A. Boorjian More articles by this author Christian Kollmannsberger More articles by this author Anne Schuckman More articles by this author Alan So More articles by this author Peter Black More articles by this author Aditya Bagrodia More articles by this author Eila Skinner More articles by this author Mehrdad Alemozaffar More articles by this author Timothy Brand More articles by this author Scott Eggener More articles by this author Phillip Pierorazio More articles by this author Kelly Stratton More articles by this author Lucia Nappi More articles by this author Craig Nichols More articles by this author Axel Heidenreich More articles by this author Siamak Daneshmand More articles by this author Expand All Advertisement PDF downloadLoading ...