Retroperitoneal Lymph Node Dissection as Primary Treatment for Metastatic Seminoma.

IF 1.8 Q3 UROLOGY & NEPHROLOGY
Advances in Urology Pub Date : 2018-02-01 eCollection Date: 2018-01-01 DOI:10.1155/2018/7978958
Brian Hu, Siamak Daneshmand
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引用次数: 18

Abstract

Reducing the long-term morbidity in testicular cancer survivors represents a major area of interest. External beam radiation therapy and systemic chemotherapy are established treatments for seminoma; however, they are associated with late toxicities such as cardiovascular disease, insulin resistance, and secondary malignancy. Retroperitoneal lymph node dissection (RPLND) is a standard treatment for nonseminomatous germ cell tumors (NSGCT) that has minimal long-term morbidity. Given the efficacy of RPLND in management of NSGCT, interest has developed in this surgery as a front-line treatment for seminoma with isolated lymph node metastasis to the retroperitoneum. Four retrospective studies have shown promising results when surgery is performed for seminomas with low-volume retroperitoneal metastases. To better determine if RPLND can be recommended as a primary treatment option, two prospective clinical trials (SEMS and PRIMETEST) are underway. This review will examine the literature, discuss the benefits/limitations of RPLND, and compare the methodologies of the two ongoing clinical trials.

腹膜后淋巴结清扫作为转移性精原细胞瘤的主要治疗方法。
降低睾丸癌幸存者的长期发病率是一个重要的研究领域。体外放射治疗和全身化疗是精原细胞瘤的常用治疗方法;然而,它们与晚期毒性有关,如心血管疾病、胰岛素抵抗和继发性恶性肿瘤。腹膜后淋巴结清扫术(RPLND)是治疗非半细胞瘤性生殖细胞肿瘤(NSGCT)的标准方法,其长期发病率极低。考虑到RPLND在NSGCT治疗中的疗效,人们对该手术作为有孤立淋巴结转移到腹膜后的精原细胞瘤的一线治疗方法产生了兴趣。四项回顾性研究表明,手术治疗小体积腹膜后转移的精原细胞瘤有很好的效果。为了更好地确定RPLND是否可以推荐作为主要治疗选择,两项前瞻性临床试验(SEMS和PRIMETEST)正在进行中。本综述将检查文献,讨论RPLND的益处/局限性,并比较两项正在进行的临床试验的方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Advances in Urology
Advances in Urology UROLOGY & NEPHROLOGY-
CiteScore
2.90
自引率
0.00%
发文量
17
审稿时长
15 weeks
期刊介绍: Advances in Urology is a peer-reviewed, open access journal that publishes state-of-the-art reviews and original research papers of wide interest in all fields of urology. The journal strives to provide publication of important manuscripts to the widest possible audience worldwide, without the constraints of expensive, hard-to-access, traditional bound journals. Advances in Urology is designed to improve publication access of both well-established urologic scientists and less well-established writers, by allowing interested scientists worldwide to participate fully.
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