Foster R S, Donohue J P
Department of Urology, University Hospital, Indianapolis, Indiana, USA.
J Urol. 2000 Jun;163(6):1788-92.
We review the rationale for the use of retroperitoneal lymph node dissection for clinical stage I nonseminomatous testis cancer.
The published literature regarding the alternative treatments for clinical stage I nonseminoma was reviewed as well as the personal experience of the authors to define the role of retroperitoneal lymph node dissection.
Retroperitoneal lymph node dissection alone is curative in 50% to 75% of patients with pathological stage II disease. The only significant long-term morbidity is a 1% chance of small bowel obstruction. If recurrence develops after retroperitoneal lymph node dissection, it is virtually always curable with cisplatin based chemotherapy.
Retroperitoneal lymph node dissection retains a therapeutic and staging capability in these patients. The probability for cure, short and long-term morbidity, and minimal need for long-term followup in these patients indicates that retroperitoneal lymph node dissection continues to be standard therapy for clinical stage I nonseminoma.
我们回顾了对临床I期非精原细胞瘤性睾丸癌采用腹膜后淋巴结清扫术的理论依据。
回顾了已发表的关于临床I期非精原细胞瘤替代治疗方法的文献以及作者的个人经验，以确定腹膜后淋巴结清扫术的作用。
单纯腹膜后淋巴结清扫术可治愈50%至75%病理分期为II期的患者。唯一显著的长期并发症是有1%的小肠梗阻几率。如果在腹膜后淋巴结清扫术后出现复发，几乎总能通过以顺铂为基础的化疗治愈。
腹膜后淋巴结清扫术在这些患者中仍具有治疗和分期能力。这些患者的治愈概率、短期和长期并发症以及对长期随访的最低需求表明，腹膜后淋巴结清扫术仍是临床I期非精原细胞瘤的标准治疗方法。
