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Survivorship Post-Retroperitoneal Lymph Node Dissection for Metastatic Testicular Cancer: A Systematic Review.
Gavin G Calpin1,2, Niall J O'Sullivan1,2, Cian Hehir2
1Department of Urology, Tallaght University Hospital, Dublin, Ireland.
Summary
Retroperitoneal lymph node dissection (RPLND) for metastatic testicular cancer offers viable oncologic outcomes. Minimally invasive techniques show improved sexual, physical, and psychological function compared to open surgery.
Area of Science:
- Urology
- Surgical Oncology
- Oncology
Background:
- Retroperitoneal lymph node dissection (RPLND) is a treatment option for metastatic testicular cancer, either post-chemotherapy or as primary therapy.
- Survivorship outcomes following RPLND, encompassing sexual, physical, and psychological function, have not been comprehensively reviewed.
Purpose of the Study:
- To conduct a systematic review analyzing survivorship outcomes after retroperitoneal lymph node dissection (RPLND) in patients with metastatic testicular cancer.
- To compare outcomes between minimally invasive and open RPLND approaches.
Main Methods:
- A systematic review was conducted adhering to PRISMA guidelines.
- Data on sexual, physical, and psychological function, complications, and oncologic outcomes were extracted from eligible studies.
Main Results:
- The review included 11 studies with 1086 patients; 80.5% had stage 1 disease, and 63.1% underwent nerve-sparing surgery.
- Minimally invasive surgery demonstrated superior sexual, physical, and psychological outcomes compared to open RPLND, with lower complication rates.
- Sexual dysfunction was more common after non-nerve-sparing procedures; recurrence rate was 7.0%.
Conclusions:
- RPLND is a feasible treatment for metastatic testicular cancer and should be considered in multidisciplinary settings.
- Minimally invasive RPLND offers better functional outcomes and acceptable oncologic results with low complication rates.
- Patients require thorough counseling regarding potential sexual dysfunction risks associated with RPLND.
