Retroperitoneal lymph node dissection in the treatment of patients with non-seminoma testicular tumours

Twelve years of experience in performing retroperitoneal lymph node dissection (RPLND) in patients with testicular non-seminomas is presented. One hundred and fifty-two procedures were performed during the years 1977-1989. Seventy-four patients had RPLND prior to chemotherapy and 78 were operated on after the initial chemotherapy. The disparity between the initial staging and intra-operative findings was 35% in the first group and 16% in the second. The mortality rate in both groups was similar (20.3% and 20.5%, respectively). Forty-one of 78 patients operated on after the initial chemotherapy had vital or only partially damaged neoplastic tissue found in the specimen. The diagnostic and therapeutic significance of RPLND is discussed and the importance of the pathological findings in planning postoperative chemotherapy, and in prognosis is stressed.