Retroperitoneal lymphadenectomy and resection for testicular cancer: an update on best practice
Therapeutic Advances in Urology, 05/07/2012
Heidenreich A et al. – In nonseminomatous testicular germ cell tumour (TGCT),postchemotherapy retroperitoneal lymph node dissection (PC–RPLND) is indicated for all residual radiographic lesions with negative or plateauing markers. Loss of antegrade ejaculation represents the most common long–term complication which can be prevented by a nerve–sparing or modified template resection. Only select patients with elevated markers who are thought to be chemorefractory might undergo desperation PC–RPLND if all radiographically visible lesions are completely resectable. PC–RPLND requires a complex surgical approach and should be performed in experienced, tertiary referral centres only.