You have accessJournal of UrologySexual Function/Dysfunction: Penis/Testis/Urethra: Benign Disease & Malignant Disease I1 Apr 2016PD34-02 IS PERCENT SEMINOMA ASSOCIATED WITH INTRAOPERATIVE MORBIDITY DURING POST-CHEMOTHERAPY RPLND? Pranav Sharma, Kamran Zargar-Shoshtari, Michael Poch, Julio Pow-Sang, Wade Sexton, Philippe Spiess, and Scott Gilbert Pranav SharmaPranav Sharma More articles by this author , Kamran Zargar-ShoshtariKamran Zargar-Shoshtari More articles by this author , Michael PochMichael Poch More articles by this author , Julio Pow-SangJulio Pow-Sang More articles by this author , Wade SextonWade Sexton More articles by this author , Philippe SpiessPhilippe Spiess More articles by this author , and Scott GilbertScott Gilbert More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.987AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To evaluate whether varying degrees of seminomatous elements in the primary orchiectomy specimen would be predictive of patient morbidity during post-chemotherapy retroperitoneal lymph node dissection (PC-RPLND) since the desmoplastic reaction with seminoma is associated with increased intraoperative complexity. METHODS We retrospectively identified 127 patients who underwent PC-RPLND for residual retroperitoneal masses. Clinicodemographic, intraoperative, and 30-day postoperative outcomes were compared for patients with pure seminoma (SEM), mixed germ cell tumors containing seminoma elements (NS+SEM), and tumors with no seminoma elements (NS). Multivariate logistic regression was used to determine independent predictors of intraoperative and postoperative 30-day complications. RESULTS We excluded 19 patients who received chemotherapy prior to orchiectomy, 2 patients with primary extragonadal GCT, and 3 patients who underwent re-do RPLND, leaving 103 patients for analysis. Fourteen patients (13.6%) had SEM, 18 (17.5%) had NS+SEM, and 71 (68.9%) had only NS elements. SEM patients were older (p=0.03), had more intraoperative blood loss (p=0.03), and were more likely to have residual seminomatous components in their post-chemotherapy LN histology (p=0.01). Percent seminoma in the orchiectomy specimen was an independent predictor of EBL >1.5 liters (odds ratio: 1.04, 95% confidence interval: 1.01 - 1.07; p=0.013) after adjusting for age, stage, IGCCC risk category, pre-op chemotherapy, number and largest LN removed, need for vascular or adjacent organ resection (including nephrectomy), and LN histology. CONCLUSIONS Higher percentage of seminoma in the orchiectomy specimen is associated with increased EBL during PC-RPLND. Percent seminoma, therefore, may be a useful prognostic tool for appropriate pre-surgical planning prior to PC-RPLND. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e839 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Pranav Sharma More articles by this author Kamran Zargar-Shoshtari More articles by this author Michael Poch More articles by this author Julio Pow-Sang More articles by this author Wade Sexton More articles by this author Philippe Spiess More articles by this author Scott Gilbert More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...