MP33-04 THE EARLY RESULTS OF THE SWENOTECA (SWEDISH NORWEGIAN TESTICULAR CANCER GROUP) INTRODUCTION OF PRIMARY RETROPERITONEAL LYMPH NODE DISSECTION (RPLND) IN SEMINOMA STAGE IIA-IIB ≤ 3cm

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP33-04 THE EARLY RESULTS OF THE SWENOTECA (SWEDISH NORWEGIAN TESTICULAR CANCER GROUP) INTRODUCTION OF PRIMARY RETROPERITONEAL LYMPH NODE DISSECTION (RPLND) IN SEMINOMA STAGE IIA-IIB ≤ 3cm Anna Thor, Axel Gerdtsson, Bjarte Almas, Dag Halvorsen, Gabriella Cohn Cedermark, Helene Neegaard, Ingrid Glimelius, Hege Sagstuen Haugnes, Asa Karlsdottir, Olof Stahl, Signe Melsen Larsen, Anna Grenabo Bergdahl, Torgrim Tandstad, and Anders Kjellman Anna ThorAnna Thor More articles by this author , Axel GerdtssonAxel Gerdtsson More articles by this author , Bjarte AlmasBjarte Almas More articles by this author , Dag HalvorsenDag Halvorsen More articles by this author , Gabriella Cohn CedermarkGabriella Cohn Cedermark More articles by this author , Helene NeegaardHelene Neegaard More articles by this author , Ingrid GlimeliusIngrid Glimelius More articles by this author , Hege Sagstuen HaugnesHege Sagstuen Haugnes More articles by this author , Asa KarlsdottirAsa Karlsdottir More articles by this author , Olof StahlOlof Stahl More articles by this author , Signe Melsen LarsenSigne Melsen Larsen More articles by this author , Anna Grenabo BergdahlAnna Grenabo Bergdahl More articles by this author , Torgrim TandstadTorgrim Tandstad More articles by this author , and Anders KjellmanAnders Kjellman More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003266.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Chemotherapy or radiotherapy have been the standard treatment for stage II seminomas with excellent results for survival but associated with significant long-term treatment-related toxicities. Several prospective trials have shown primary retroperitoneal lymph node dissection (RPLND) to be effective and safe as an alternative treatment. These results made us change the guidelines in the latest update of the SWENOTECA treatment program making surgery with RPLND the primary treatment modality in seminoma stage IIA to IIB ≤ 3 cm with 1-2 metastatic nodes. We have done an update of the result of the patients treated by the new management program. METHODS: The RPLND surgery in Sweden and Norway are centralised to 5 hospitals all participating in this study. In the study we included both patients with recurrence after initial stage I disease and patients with stage IIA and B at diagnosis. The patients were operated between 2019 and 2022. We collected information on operation time, bleeding, peri- and postoperative complications. We also analysed the histology and if adjuvant chemotherapy was given. We followed the patients for any recurrence of disease. RESULTS: We have included 61 patients operated from January 2019 to September 2022. The number of operations per site varied from 4 to 22. The mean age of patients at time of RPLND was 42.6 years (range 25-79). 38 patients had stage I disease at diagnosis and a recurrence. 23 patients had stage IIA or IIB disease at diagnosis. At time of RPLND 46 patients had IIA-disease and 14 stage IIB-disease (one missing data). The histology from RPLND showed seminoma in 56 patients, necrosis in two patients, teratoma in one patient (two missing data). 24 patients were operated with robotic laparoscopic technique. Seven patients out of 61 had a Clavien-Dindo postoperative complication > 2. The patients have been followed for a median of 17 months (range 2-45). Five patients have had recurrences, three in operated template and two outside templates. CONCLUSIONS: Our early results of primary RPLND of seminomas IIA-IIB ≤ 3 cm, show promising results. Longer follow-up is required to fully ensure that this is a safe treatment option. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e451 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Anna Thor More articles by this author Axel Gerdtsson More articles by this author Bjarte Almas More articles by this author Dag Halvorsen More articles by this author Gabriella Cohn Cedermark More articles by this author Helene Neegaard More articles by this author Ingrid Glimelius More articles by this author Hege Sagstuen Haugnes More articles by this author Asa Karlsdottir More articles by this author Olof Stahl More articles by this author Signe Melsen Larsen More articles by this author Anna Grenabo Bergdahl More articles by this author Torgrim Tandstad More articles by this author Anders Kjellman More articles by this author Expand All Advertisement PDF downloadLoading ...