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Published in: World Journal of Urology 8/2017

01-08-2017 | Topic Paper

Residual tumor resection (RTR)

Authors: A. Lusch, P. Albers

Published in: World Journal of Urology | Issue 8/2017

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Abstract

Residual tumor resection in patients with advanced testicular tumor plays a vital role in the multimodal treatment. Treatment indications for residual tumor resection have changed over the last two decades. While patients with advanced seminoma after chemotherapy or radiotherapy rarely need surgery, it is mandatory for most non-seminomatous tumor patients to undergo post-chemotherapy tumor resection. Due to adjunctive surgical procedures, the operation is surgically demanding and should be performed only in specialized high-volume referral centers. Additional surgical procedures such as nephrectomy, partial colectomy or vascular interventions including caval and aortic resection with grafting might be required. Consequently, several complications can be seen in the peri- and postoperative course. We aim to describe indications for residual tumor resection, operative technique, including adjunctive surgeries and the most common peri- and postoperative complications.
Literature
1.
go back to reference American Cancer Society (2016) Cancer facts and figures 2016. American Cancer Society, Atlanta American Cancer Society (2016) Cancer facts and figures 2016. American Cancer Society, Atlanta
2.
go back to reference Skakkebaek NE, Rajpert-De Meyts E, Main KM (2001) Testicular dysgenesis syndrome: an increasingly common developmental disorder with environmental aspects. Hum Reprod 16(5):972–978CrossRefPubMed Skakkebaek NE, Rajpert-De Meyts E, Main KM (2001) Testicular dysgenesis syndrome: an increasingly common developmental disorder with environmental aspects. Hum Reprod 16(5):972–978CrossRefPubMed
3.
go back to reference Hoffmann R, Plug I, McKee M et al (2014) Innovations in health care and mortality trends from five cancers in seven European countries between 1970 and 2005. Int J Public Health 59(2):341–350CrossRefPubMed Hoffmann R, Plug I, McKee M et al (2014) Innovations in health care and mortality trends from five cancers in seven European countries between 1970 and 2005. Int J Public Health 59(2):341–350CrossRefPubMed
4.
go back to reference Mead GM, Stenning SP (1997) The International germ cell consensus classification: a new prognostic factor-based staging classification for metastatic germ cell tumours. Clin Oncol (R Coll Radiol) 9(4):207–209CrossRef Mead GM, Stenning SP (1997) The International germ cell consensus classification: a new prognostic factor-based staging classification for metastatic germ cell tumours. Clin Oncol (R Coll Radiol) 9(4):207–209CrossRef
5.
go back to reference Carver BS, Serio AM, Bajorin D et al (2007) Improved clinical outcome in recent years for men with metastatic nonseminomatous germ cell tumors. J Clin Oncol 25(35):5603–5608CrossRefPubMed Carver BS, Serio AM, Bajorin D et al (2007) Improved clinical outcome in recent years for men with metastatic nonseminomatous germ cell tumors. J Clin Oncol 25(35):5603–5608CrossRefPubMed
6.
go back to reference Kollmannsberger C, Daneshmand S, So A et al (2010) Management of disseminated nonseminomatous germ cell tumors with risk-based chemotherapy followed by response-guided postchemotherapy surgery. J Clin Oncol 28(4):537–542CrossRefPubMed Kollmannsberger C, Daneshmand S, So A et al (2010) Management of disseminated nonseminomatous germ cell tumors with risk-based chemotherapy followed by response-guided postchemotherapy surgery. J Clin Oncol 28(4):537–542CrossRefPubMed
7.
go back to reference Ehrlich Y, Brames MJ, Beck SD et al (2010) Long-term follow-up of Cisplatin combination chemotherapy in patients with disseminated nonseminomatous germ cell tumors: is a postchemotherapy retroperitoneal lymph node dissection needed after complete remission? J Clin Oncol 28(4):531–536CrossRefPubMed Ehrlich Y, Brames MJ, Beck SD et al (2010) Long-term follow-up of Cisplatin combination chemotherapy in patients with disseminated nonseminomatous germ cell tumors: is a postchemotherapy retroperitoneal lymph node dissection needed after complete remission? J Clin Oncol 28(4):531–536CrossRefPubMed
8.
go back to reference Albers P, Melchior D, Müller SC (2003) Surgery in metastatic testicular cancer. Eur Urol 44(2):233–244 (Review) CrossRefPubMed Albers P, Melchior D, Müller SC (2003) Surgery in metastatic testicular cancer. Eur Urol 44(2):233–244 (Review) CrossRefPubMed
9.
go back to reference Baniel J, Foster RS, Einhorn LH et al (1995) Late relapse of clinical stage I testicular cancer. J Urol 154(4):1370–1372CrossRefPubMed Baniel J, Foster RS, Einhorn LH et al (1995) Late relapse of clinical stage I testicular cancer. J Urol 154(4):1370–1372CrossRefPubMed
10.
go back to reference Donohue JP, Zachary JM, Maynard BR (1982) Distribution of nodal metastases in nonseminomatous testis cancer. J Urol 128(2):315–320CrossRefPubMed Donohue JP, Zachary JM, Maynard BR (1982) Distribution of nodal metastases in nonseminomatous testis cancer. J Urol 128(2):315–320CrossRefPubMed
11.
go back to reference Lusch A, Zaum M, Albers P (2015) Unilateral and nerve-sparing postchemotherapy retroperitoneal lymph node dissection (PC-RPLND) in patients with non-seminomatous germ cell tumors—indication and recurrence rates. EAU, Madrid Lusch A, Zaum M, Albers P (2015) Unilateral and nerve-sparing postchemotherapy retroperitoneal lymph node dissection (PC-RPLND) in patients with non-seminomatous germ cell tumors—indication and recurrence rates. EAU, Madrid
12.
go back to reference Zaum M, Lusch A, Winter C et al (2015) Complications and additional surgical procedures for retroperitoneal lymph node dissection (RPLND) in advanced germ cell tumors—a single center experience. EAU, Madrid Zaum M, Lusch A, Winter C et al (2015) Complications and additional surgical procedures for retroperitoneal lymph node dissection (RPLND) in advanced germ cell tumors—a single center experience. EAU, Madrid
13.
go back to reference Djaladat H, Nichols C, Daneshmand S (2012) Adjuvant surgery in testicular cancer patients undergoing postchemotherapy retroperitoneal lymph node dissection. Ann Surg Oncol 19(7):2388–2393CrossRefPubMed Djaladat H, Nichols C, Daneshmand S (2012) Adjuvant surgery in testicular cancer patients undergoing postchemotherapy retroperitoneal lymph node dissection. Ann Surg Oncol 19(7):2388–2393CrossRefPubMed
14.
go back to reference Stephenson AJ, Tal R, Sheinfeld J (2006) Adjunctive nephrectomy at post-chemotherapy retroperitoneal lymph node dissection for nonseminomatous germ cell testicular cancer. J Urol 176(5):1996–1999CrossRefPubMed Stephenson AJ, Tal R, Sheinfeld J (2006) Adjunctive nephrectomy at post-chemotherapy retroperitoneal lymph node dissection for nonseminomatous germ cell testicular cancer. J Urol 176(5):1996–1999CrossRefPubMed
15.
go back to reference Winter C, Pfister D, Busch J et al (2012) Residual tumor size and IGCCCG risk classification predict additional vascular procedures in patients with germ cell tumors and residual tumor resection: a multicenter analysis of the German Testicular Cancer Study Group. Eur Urol 61(2):403–409CrossRefPubMed Winter C, Pfister D, Busch J et al (2012) Residual tumor size and IGCCCG risk classification predict additional vascular procedures in patients with germ cell tumors and residual tumor resection: a multicenter analysis of the German Testicular Cancer Study Group. Eur Urol 61(2):403–409CrossRefPubMed
16.
go back to reference Albers P, Bingoel C, Witthuhn R et al (2009) Complications of postchemotherapy residual tumor resection in patients with germ cell cancer. J Clin Oncol 27(suppl; abstr e16077) Albers P, Bingoel C, Witthuhn R et al (2009) Complications of postchemotherapy residual tumor resection in patients with germ cell cancer. J Clin Oncol 27(suppl; abstr e16077)
17.
go back to reference Baniel J, Foster RS, Rowland RG et al (1995) Complications of post-chemotherapy retroperitoneal lymph node dissection. J Urol 153(3 Pt 2):976–980PubMed Baniel J, Foster RS, Rowland RG et al (1995) Complications of post-chemotherapy retroperitoneal lymph node dissection. J Urol 153(3 Pt 2):976–980PubMed
18.
go back to reference Luz MA, Kotb AF, Aldousari S et al (2010) Retroperitoneal lymph node dissection for residual masses after chemotherapy in nonseminomatous germ cell testicular tumor. World J Surg Oncol 8:97CrossRefPubMedPubMedCentral Luz MA, Kotb AF, Aldousari S et al (2010) Retroperitoneal lymph node dissection for residual masses after chemotherapy in nonseminomatous germ cell testicular tumor. World J Surg Oncol 8:97CrossRefPubMedPubMedCentral
19.
go back to reference Heidenreich A, Ohlmann C, Hegele A (2005) Repeat retroperitoneal lymphadenectomy in advanced testicular cancer. Eur Urol 47(1):64–71CrossRefPubMed Heidenreich A, Ohlmann C, Hegele A (2005) Repeat retroperitoneal lymphadenectomy in advanced testicular cancer. Eur Urol 47(1):64–71CrossRefPubMed
20.
go back to reference Heidenreich A, Albers P, Hartmann M et al (2003) Complications of primary nerve sparing retroperitoneal lymph node dissection for clinical stage I nonseminomatous germ cell tumors of the testis: experience of the German Testicular Cancer Study Group. J Urol 169(5):1710–1714CrossRefPubMed Heidenreich A, Albers P, Hartmann M et al (2003) Complications of primary nerve sparing retroperitoneal lymph node dissection for clinical stage I nonseminomatous germ cell tumors of the testis: experience of the German Testicular Cancer Study Group. J Urol 169(5):1710–1714CrossRefPubMed
21.
go back to reference Cary KC, Beck S, Bihrle R et al (2013) Clinical and pathological features predictive of nephrectomy at post-chemotherapy retroperitoneal lymph node dissection. J Urol 189(3):812–817CrossRefPubMed Cary KC, Beck S, Bihrle R et al (2013) Clinical and pathological features predictive of nephrectomy at post-chemotherapy retroperitoneal lymph node dissection. J Urol 189(3):812–817CrossRefPubMed
22.
go back to reference Cary C, Masterson TA, Bihrle R et al (2015) Contemporary trends in postchemotherapy retroperitoneal lymph node dissection: Additional procedures and perioperative complications. Urol Oncol 33(9):389.e15–389.e21CrossRef Cary C, Masterson TA, Bihrle R et al (2015) Contemporary trends in postchemotherapy retroperitoneal lymph node dissection: Additional procedures and perioperative complications. Urol Oncol 33(9):389.e15–389.e21CrossRef
Metadata
Title
Residual tumor resection (RTR)
Authors
A. Lusch
P. Albers
Publication date
01-08-2017
Publisher
Springer Berlin Heidelberg
Published in
World Journal of Urology / Issue 8/2017
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-016-1984-2

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