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Robotic retroperitoneal lymph node dissection for primary and post-chemotherapy testis cancer
G J Nason1, K Kuhathaas1, L Anson-Cartwright1
1Division of Urology, Department of Surgery, Princess Margaret Cancer Centre, 610 University Avenue, Suite 3-130, Toronto, ON, M5G 1X5, Canada.
Journal of Robotic Surgery
|May 13, 2021
Summary
Robotic retroperitoneal lymph node dissection (RPLND) for testicular cancer is safe and feasible. Further follow-up is needed to confirm oncological outcomes match open surgery, especially for patients with viable tumors or teratoma.
Area of Science:
- Urology
- Surgical Oncology
- Robotic Surgery
Background:
- Retroperitoneal lymph node dissection (RPLND) is a key treatment for testicular cancer.
- Robotic RPLND offers a minimally invasive approach with established oncological principles.
Purpose of the Study:
- To evaluate the 2-year oncological outcomes of robotic RPLND.
- To assess the safety and feasibility of robotic RPLND in a single-institution setting.
Main Methods:
- Retrospective review of 141 patients undergoing robotic RPLND between 2014 and 2020.
- Analysis of demographic, perioperative, and oncologic data, including nerve-sparing techniques.
- Focus on patients with primary or post-chemotherapy indications, including those with viable tumor or teratoma.
Main Results:
- 141 patients underwent robotic RPLND; 27 had bilateral nerve-sparing procedures.
- Median operative time was 525 minutes with 200 ml blood loss; median length of stay was 2 days.
- Viable tumor or teratoma found in 63% and 33.3% of resected specimens, respectively; 11.1% relapsed.
Conclusions:
- Robotic RPLND can be performed safely with acceptable perioperative outcomes.
- Long-term oncological outcomes require further evaluation, particularly in complex cases.
- Comparison with open RPLND necessitates extended follow-up data.
