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Primary retroperito...
Primary retroperitoneal lymph node dissection as treatment for low-volume metastatic seminoma in a population-based cohort : the Swedish Norwegian testicular cancer group experience
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- Thor, Anna (författare)
- Department of Clinical Science, Intervention and Technology, Division of Urology, Karolinska Institute, Stockholm, Sweden; Department of Urology, Pelvic Cancer, Karolinska University Hospital, Stockholm, Sweden
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- Negaard, Helene F.S. (författare)
- Department of Oncology, Oslo University Hospital, Oslo, Norway
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- Grenabo Bergdahl, Anna (författare)
- Department of Urology, Institute of Clinical Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Urology, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
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- Almås, Bjarte (författare)
- Department of Urology, Haukeland University Hospital, Bergen, Norway
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- Melsen Larsen, Signe (författare)
- Department of Urology, Oslo University Hospital, Oslo, Norway
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- Lundgren, Per-Olof (författare)
- Department of Clinical Science, Intervention and Technology, Division of Urology, Karolinska Institute, Stockholm, Sweden; Department of Urology, Pelvic Cancer, Karolinska University Hospital, Stockholm, Sweden
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- Gerdtsson, Axel (författare)
- Department of Clinical Science, Intervention and Technology, Division of Urology, Karolinska Institute, Stockholm, Sweden; Department of Urology, Skåne University Hospital, Malmö, Sweden; Institution of Translational Medicine, Lund University, Malmö, Sweden
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- Halvorsen, Dag (författare)
- Department of Urology, St. Olavs University Hospital, Trondheim, Norway
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- Johannsdottir, Berglind (författare)
- Department of Pelvic Cancer, Genitourinary Oncology Unit, Karolinska University Hospital, Stockholm, Sweden
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- Jansson, Anna K. (författare)
- Department of Immunology, Genetics & Pathology, Cancer Precision Medicine, Uppsala University, Uppsala, Sweden
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- Hellström, Martin (författare)
- Umeå universitet,Onkologi
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- Wahlqvist, Rolf (författare)
- Department of Urology, Oslo University Hospital, Oslo, Norway
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- Langberg, Carl W. (författare)
- The Cancer Centre, Oslo University Hospital, Oslo, Norway
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- Hedlund, Annika (författare)
- Department of Oncology, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
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- Akre, Olof (författare)
- Department of Urology, Pelvic Cancer, Karolinska University Hospital, Stockholm, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
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- Glimelius, Ingrid (författare)
- Department of Immunology, Genetics & Pathology, Cancer Precision Medicine, Uppsala University, Uppsala, Sweden
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- Ståhl, Olof (författare)
- Department of Oncology, Skåne University Hospital, Lund, Sweden; Department of Clinical Sciences, Lund University, Lund, Sweden
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- Haugnes, Hege Sagstuen (författare)
- Department of Oncology, University Hospital of North Norway, Tromsø, Norway; Department of Clinical Medicine, UIT – The Arctic University of Norway, Tromsø, Norway
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- Cohn-Cedermark, Gabriella (författare)
- Department of Pelvic Cancer, Genitourinary Oncology Unit, Karolinska University Hospital, Stockholm, Sweden; Department of Oncology - Pathology, Karolinska Institute, Stockholm, Sweden
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- Kjellman, Anders (författare)
- Department of Clinical Science, Intervention and Technology, Division of Urology, Karolinska Institute, Stockholm, Sweden; Department of Urology, Pelvic Cancer, Karolinska University Hospital, Stockholm, Sweden
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- Tandstad, Torgrim (författare)
- The Cancer Clinic, St. Olavs University Hospital, Trondheim, Norway; Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
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(creator_code:org_t)
- Elsevier, 2024
- 2024
- Engelska.
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Ingår i: European Urology Open Science. - : Elsevier. - 2666-1691 .- 2666-1683. ; 65, s. 13-19
- Relaterad länk:
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https://doi.org/10.1...
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https://umu.diva-por... (primary) (Raw object)
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Background and objective: There is an unmet need to avoid long-term morbidity associated with standard cytotoxic treatment for low-volume metastatic seminoma. Our aim was to assess the oncological efficacy and surgical safety of retroperitoneal lymph node dissection (RPLND) as treatment in a population-based cohort of metastatic seminoma patients with limited retroperitoneal lymphadenopathy.Methods: Sixty-two seminoma patients in Norway and Sweden were included in the cohort from 2019 to 2022. Patients with lymphadenopathy ≤3 cm, having primary clinical stage (CS) IIA/B or CS I with a relapse, were operated with uni- or bilateral template RPLND, open or robot assisted. The outcome measures included surgical complications as per Clavien-Dindo, and Kaplan-Meier survival estimates for 24-mo progression-free survival (PFS) and overall survival (OS).Key findings and limitations: In the cohort, 33 (53%) had CS I with a relapse during surveillance, six (10%) CS I with a relapse following adjuvant chemotherapy, and 23 (37%) initial CS IIA/B. Metastatic seminoma was verified in 58 patients (94%) with a median largest diameter of 18 mm (interquartile range [IQR] 13–24). Robot-assisted RPLND was performed in 40 patients (65%). Clavien-Dindo III complications were observed in three patients (5%); no grade ≥IV complications occurred. Eighteen patients (29%) received adjuvant chemotherapy after surgery. The median follow-up was 23 mo (IQR 16–30), and recurrence occurred in six patients (10%) after a median of 8 mo (IQR 4–14). PFS was 90% (95% confidence interval: 0.86–1) and OS was 100% at 24 mo.Conclusions and clinical implications: RPLND as primary treatment is an option for selected low-stage seminomas with a limited burden of disease, showing low complications and low relapse rates, with the potential to reduce long-term morbidity.Patient summary: In seminoma patients with limited metastatic spread, surgery is a treatment option offering an alternative to chemotherapy or radiation. This paper covers the first 62 patients operated in Norway and Sweden.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Urologi och njurmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Urology and Nephrology (hsv//eng)
Nyckelord
- Germ cell cancer
- Metastatic
- Retroperitoneal
- Retroperitoneal lymph node dissection
- Robotic surgery
- Seminoma
- Testicular
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- art (ämneskategori)
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Thor, Anna
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Negaard, Helene ...
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Grenabo Bergdahl ...
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Almås, Bjarte
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Melsen Larsen, S ...
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Lundgren, Per-Ol ...
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Gerdtsson, Axel
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Halvorsen, Dag
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Johannsdottir, B ...
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Jansson, Anna K.
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Hellström, Marti ...
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Wahlqvist, Rolf
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Langberg, Carl W ...
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Hedlund, Annika
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Akre, Olof
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Glimelius, Ingri ...
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Ståhl, Olof
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Haugnes, Hege Sa ...
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Cohn-Cedermark, ...
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Kjellman, Anders
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Tandstad, Torgri ...
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