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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 10/2011

01-10-2011 | Urologic Oncology

Trends of Retroperitoneal Lymphadenectomy Use in Patients with Nonseminomatous Germ Cell Tumor of the Testis: A Population-Based Study

Authors: Maxine Sun, BSc, Firas Abdollah, MD, Lars Budaüs, MD, Daniel Liberman, MD, Zhe Tian, BSc, Monica Morgan, MD, Rupinder Johal, MD, Jan Schmitges, MD, Shahrokh F. Shariat, MD, Francesco Montorsi, MD, Markus Greafen, MD, Paul Perrotte, MD, Pierre I. Karakiewicz, MD

Published in: Annals of Surgical Oncology | Issue 10/2011

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Abstract

Background

Retroperitoneal lymphadenectomy (RPLND), chemotherapy, and active surveillance represent treatment options for patients with nonseminomatous germ-cell tumors of the testis (NSGCTT). Our objective was to assess the utilization rate of RPLND in patients with NSGCTT.

Methods

Within the Surveillance, Epidemiology and End Results (SEER) cohort, 4,620 and 1,671 patients with stage I and II NSGCTT were diagnosed between the years 1988 and 2006. Univariable and multivariable logistic regression analyses were performed to test the predictors of RPLND use in respectively patients with stage I and II NSGCTT.

Results

The rate of RPLND according to stage I and II was 27 and 58%, respectively. In patients with stage I disease, the rate of RPLND decreased from 39% in 1988–1995 to 18% in 2004–2006 (P < 0.001), and remained stable for stage II patients (62–56%, P = 0.2). Regional variability existed regarding the rate of RPLND use only in stage I (Utah: 51% vs. Louisiana: 16%). Multivariable analyses performed in stage I NSGCTT revealed that year of diagnosis, SEER registry, and age were significant predictors of RPLND use. However, none of these variables achieved statistical significance within stage II NSGCTT patients.

Conclusions

In patients with stage I NSGCCT, the RPLND utilization rate decreased during the study span. This observation may be ascribed to wider use of surveillance or chemotherapy. No temporal difference was recorded in patients with stage II NSGCCT.
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Metadata
Title
Trends of Retroperitoneal Lymphadenectomy Use in Patients with Nonseminomatous Germ Cell Tumor of the Testis: A Population-Based Study
Authors
Maxine Sun, BSc
Firas Abdollah, MD
Lars Budaüs, MD
Daniel Liberman, MD
Zhe Tian, BSc
Monica Morgan, MD
Rupinder Johal, MD
Jan Schmitges, MD
Shahrokh F. Shariat, MD
Francesco Montorsi, MD
Markus Greafen, MD
Paul Perrotte, MD
Pierre I. Karakiewicz, MD
Publication date
01-10-2011
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 10/2011
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-011-1722-3

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