1. Lymph node density in retroperitoneal lymph node dissection as a novel marker for predicting recurrence in patients with germ cell testicular cancer: A case-control study and long-term clinical experience of a tertiary referral hospital
- Author
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Bahadır Topuz, Nejdet Karsiyakali, Savaş Sarıkaya, Turgay Ebiloglu, Engin Kaya, and Murat Zor
- Subjects
Adult ,Male ,medicine.medical_specialty ,Time Factors ,Adolescent ,medicine.medical_treatment ,030232 urology & nephrology ,Urology ,Tertiary Care Centers ,03 medical and health sciences ,Retroperitoneal lymph node dissection ,Young Adult ,0302 clinical medicine ,Testicular Neoplasms ,Predictive Value of Tests ,Medicine ,Humans ,Retroperitoneal Space ,Lymph node ,Testicular cancer ,Tumor marker ,Aged ,Retrospective Studies ,Inguinal orchiectomy ,business.industry ,General Medicine ,Seminoma ,Middle Aged ,Neoplasms, Germ Cell and Embryonal ,medicine.disease ,Radiation therapy ,medicine.anatomical_structure ,Case-Control Studies ,Lymph Node Excision ,Germ cell tumors ,Lymph Nodes ,Neoplasm Recurrence, Local ,business ,Follow-Up Studies - Abstract
Introduction and objectives In this retrospective study, we aimed to evaluate lymph node (LN) density in retroperitoneal lymph node dissection (RPLND) to analyze whether residual mass after chemotherapy might behave as predicting factor for recurrence in patients with germ cell testicular cancer (GCTC). Materials and methods The data of 185 patients that were operated between 12/2004 and 02/2017 because of GCTC were reviewed retrospectively. LN density was calculated. The patients were compared statistically in terms of demographic features, tumor characteristics, serum tumor marker levels, treatment strategies, and pathological results according to GCTC subtypes. Correlation analysis was performed to determine the parameters related to recurrent disease. Results The median follow-up was 79 (31–179) months and the median age of the patients was 23 (16–71). The median tumor size was 4 (1–18) cm. Five (2.7%) patients had metastatic disease at initial diagnosis. Seminoma, non-seminomatous-GCT and mix type-GCTC was detected in 62 (33.5%), 60 (32.4%) and 63 (34.1%) patients, respectively. Following inguinal orchiectomy, 48 (25.9%) patients underwent follow-up, 126 (68.1%) patients underwent chemotherapy and 11 (5.9%) patients underwent radiotherapy. A total of 21 (11.4%) patients underwent post-chemotherapy RPLND. Early and late recurrence was seen in 3 (1.6%) and 2 (1.1%) of the patients, respectively. A mild to moderate, negative, but significant correlation was found between the recurrence and the number of LNs containing metastatic deposits and LN density (r = −0.490, p = 0.024 and r = −0.450, p = 00.041, respectively). Conclusions There was a negative correlation between the number of LNs containing metastatic deposits and LN density and recurrent disease.
- Published
- 2019