You have accessJournal of UrologyPlenary Session I - Best Abstracts1 Apr 2015PI-10 DECLINING RATES OF RETROPERITONEAL LYMPH NODE DISSECTION FOR STAGE I NON-SEMINOMATOUS GERM CELL TUMORS: RESULTS FROM THE NATIONAL CANCER DATABASE Mohammed Haseebuddin, Elizabeth Handorf, Alexander Kutikov, Nikhil Wainganker, Yu-Ning Wong, Elizabeth Plimack, Robert Uzzo, and Marc Smaldone Mohammed HaseebuddinMohammed Haseebuddin More articles by this author , Elizabeth HandorfElizabeth Handorf More articles by this author , Alexander KutikovAlexander Kutikov More articles by this author , Nikhil WaingankerNikhil Wainganker More articles by this author , Yu-Ning WongYu-Ning Wong More articles by this author , Elizabeth PlimackElizabeth Plimack More articles by this author , Robert UzzoRobert Uzzo More articles by this author , and Marc SmaldoneMarc Smaldone More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2909AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Per existing best practice guidelines, careful observation with serial imaging (active surveillance) or primary chemotherapy have supplanted primary retroperitoneal lymph node dissection (RPLND) for stage I non-seminomatous germ cell tumors (NSGCT). Hypothesizing that rates of primary RPLND have declined over the past decade, our objective was to assess temporal trends in primary treatment for stage I NSGCT using a large national cancer registry. METHODS The National Cancer Database (NCDB) was queried for all patients diagnosed with stage I NSGCT from 1998-2011. Temporal trends for receipt of primary RPLND, chemotherapy, or observation (defined as no treatment) were assessed. Adjusting for patient, demographics (age, ethnicity, race, insurance status, education, income, geographic location), and clinicopathologic characteristics (stage), multivariable logistic models were used to examine the association between available covariates and receipt of primary RPLND. RESULTS Of 15,822 patients identified over the study period, 9001 (56.9%), 2937 (18.6%), and 3884 (24.5%) underwent observation, RPLND, and chemotherapy respectively. While rates of observation minimally changed over time (56.3 to 55.0%, p=0.85), a significant decrease in utilization of RPLND (23.0 to 12.4%, p<0.001) was matched by a significant increase in receipt of primary chemotherapy (20.7 to 32.5%, p<0.001). Rates of RPLND declined across all age groups-age < 30 (24.3% to 12.1%, P<0.0001), age 30-39 (21.6% to 13.8%, p <0.0001), age 40-49 (23.1% to 11.4%, p<0.0001), age>50 (20.0% to 11.7%, p = 0.02). Following adjustment, stage T2 (OR 0.79 [CI 0.72-0.87]) and T3 (OR 0.33 [CI 0.24-0.96]), and age categories 40-49 years (OR 0.83 [CI 0.72-0.94]) and ≥50 years (OR 0.66 [CI 0.52-0.82]) were associated with decreased utilization of RPLND. CONCLUSIONS In hospitals reporting to the NCDB, utilization of primary RPLND for stage I NSGCT has significantly decreased over the last decade, while receipt of primary chemotherapy has increased over the same period. While employed in more than 50% of patients, rates of observation remain unchanged. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e983 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mohammed Haseebuddin More articles by this author Elizabeth Handorf More articles by this author Alexander Kutikov More articles by this author Nikhil Wainganker More articles by this author Yu-Ning Wong More articles by this author Elizabeth Plimack More articles by this author Robert Uzzo More articles by this author Marc Smaldone More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...