You have accessJournal of UrologyPenis/Testis/Urethra: Benign & Malignant Disease1 Apr 2011973 LAPAROSCOPIC RETROPERITONEAL LYMPH-NODE DISSECTION (L-RPLND): EVOLUTION TOWARDS A SINGLE-STATEGY MANAGEMENT IN CLINICAL STAGE I (CS I) NON-SEMINOMATOUS GERM-CELL TUMORS OF THE TESTIS (NSGCTT) Nicola Nicolai, Davide Biasoni, Mario Catanzaro, Silvia Stagni, Tullio Torelli, Andrea Necchi, Luigi Piva, Angelo Milani, Giorgio Pizzocaro, and Roberto Salvioni Nicola NicolaiNicola Nicolai Milano, Italy More articles by this author , Davide BiasoniDavide Biasoni Milano, Italy More articles by this author , Mario CatanzaroMario Catanzaro Milano, Italy More articles by this author , Silvia StagniSilvia Stagni Milano, Italy More articles by this author , Tullio TorelliTullio Torelli Milano, Italy More articles by this author , Andrea NecchiAndrea Necchi Milano, Italy More articles by this author , Luigi PivaLuigi Piva Milano, Italy More articles by this author , Angelo MilaniAngelo Milani Milano, Italy More articles by this author , Giorgio PizzocaroGiorgio Pizzocaro Milano, Italy More articles by this author , and Roberto SalvioniRoberto Salvioni Milano, Italy More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.984AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES L-RPLND remains a controversial procedure for CS I NSGCTT patients (pts). Long-term efficacy has not been unraveled yet, as most of the pts with nodal metastases at RPLND undergo adjuvant chemotherapy (CT). METHODS We analyzed the data of 155 L-RPLND between July 1999 and October 2010. Two/thirds of patients had neither vascular invasion nor embryonal carcinoma component > 90% in primary tumor. Median number of removed nodes was 14 (IQR 10–19). Nodal metastases (pN+) were found in 18 (12%) pts, and 7 of them underwent adjuvant CT. Since October 2008, only patients with nodal metastasis having tumor density greater than 20% were candidate to adjuvant CT (2/8). All patients underwent a follow-up program. RESULTS After a median follow-up of 36 months, 9 patients (6%) relapsed, all of them occurring within 6 months. None the 7 patients who underwent adjuvant CT relapsed. Five (4%) relapses occurred among 137 patients with no nodal metastases while 4 (36%) occurred among 11 patients with nodal metastases not receiving adjuvant CT. Among the 8 pN+ pts recorded since Oct 2008, 2 underwent adjuvant chemotherapy and 6 were observed, 1/6 (17%) relapsing at 3 months. CONCLUSIONS The rate of relapses following L-RPLND compares with the data of open procedure. We had not an excess of relapses among pN0 patients. In the few pN+ patients not undergoing adjuvant chemotherapy we are experiencing results that seem to be comparable with open series. Mature results of L-RPLND in referral centers would endow the procedure of substantial reliability and less invasiveness than open RPLND to be fully discussed as an alternative for CSI NSGCTT pts. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e392-e393 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Nicola Nicolai Milano, Italy More articles by this author Davide Biasoni Milano, Italy More articles by this author Mario Catanzaro Milano, Italy More articles by this author Silvia Stagni Milano, Italy More articles by this author Tullio Torelli Milano, Italy More articles by this author Andrea Necchi Milano, Italy More articles by this author Luigi Piva Milano, Italy More articles by this author Angelo Milani Milano, Italy More articles by this author Giorgio Pizzocaro Milano, Italy More articles by this author Roberto Salvioni Milano, Italy More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...