Effectiveness and morbidity of secondary retroperitoneal lymph node dissection after chemotherapy in testicular...

Addition of surgery to cytoreductive chemotherapy has increased the number of patients with complete remission after advanced testicular cancer. In this report, we present the morbidity of complete retroperitoneal lymph node dissection following aggressive chemotherapy in 10 of these patients. Although no mortality and no postoperative major complications were registered in our series, there were high morbidity rates during operation represented by single or multiple dehiscences of the inferior vena cava and/or renal vein (7 cases), aortic graft for aortic dehiscence (1 case), partial sigmoidectomy after inferior mesenteric artery division (1 case with previous retroperitoneal radiotherapy), total nephrectomy (2 cases), and suprarenalectomy (5 cases). Because the overall possible benefit of chemotherapy-surgery combination was seen in 7 of our 10 stage III-B4 patients, we believe that the combined approach is the best option for treating advanced retroperitoneal testicular cancer and its results justify the morbidity due to lymphadenectomy.