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Erschienen in:

10.03.2021 | Urologic Oncology

Retroperitoneal Lymph Node Dissection Versus Surveillance for Adult Early Stage Pure Testicular Teratoma: A Nationwide Analysis

verfasst von: Ali Hajiran, MD, Mounsif Azizi, MD, Ahmet M. Aydin, MD, Nicholas H. Chakiryan, MD, Charles C. Peyton, MD, David C. Boulware, PhD, Brandon J. Manley, MD, Scott M. Gilbert, MD, Wade J. Sexton, MD

Erschienen in: Annals of Surgical Oncology | Ausgabe 7/2021

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Abstract

Purpose

Following radical orchiectomy, surveillance and primary retroperitoneal lymph node dissection (RPLND) are acceptable options for the management of early stage pure testicular teratoma in adult patients; however, there is no uniform consensus. The aim of this study was to investigate survival outcomes of adults with early stage pure testicular teratoma based on management strategy.

Methods

Data was extracted from the National Cancer Database (NCDB) from testicular cancer patients diagnosed with clinical stage (CS) I pure teratoma (pT1-4N0M0S0) between 2004 and 2014. Kaplan-Meier and Cox regression analyses were used to assess clinical outcomes based on management strategy.

Results

Of the 61,167 patients diagnosed with testicular cancer, 692 (1.1%) had pure teratoma. Only individuals with CS I disease were considered (n = 237). The median age was 28 (23–35) years. Overall, 43 (18%) patients underwent RPLND and 194 (82%) patients were managed with surveillance. There was an increase in surveillance for CS I teratoma during the study period. Increasing distance from residence to treatment facility was an unadjusted predictor for undergoing primary RPLND (p < 0.001). Median follow-up was 54 months and there was no significant difference in overall survival between CS I teratoma patients managed with RPLND and those managed with surveillance (p = 0.13).

Conclusions

There has been a trend toward increasing adoption of surveillance for the management of early stage pure testicular teratoma in adults. Our findings suggest that surveillance provides comparable survival outcomes to primary retroperitoneal lymph node dissection in this setting.
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Metadaten
Titel
Retroperitoneal Lymph Node Dissection Versus Surveillance for Adult Early Stage Pure Testicular Teratoma: A Nationwide Analysis
verfasst von
Ali Hajiran, MD
Mounsif Azizi, MD
Ahmet M. Aydin, MD
Nicholas H. Chakiryan, MD
Charles C. Peyton, MD
David C. Boulware, PhD
Brandon J. Manley, MD
Scott M. Gilbert, MD
Wade J. Sexton, MD
Publikationsdatum
10.03.2021
Verlag
Springer International Publishing
Erschienen in
Annals of Surgical Oncology / Ausgabe 7/2021
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-021-09696-3

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