Alanee Shaheen R, Carver Brett S, Feldman Darren R, Motzer Robert J, Bosl George J, Sheinfeld Joel
Department of Surgery, Division of Urology, Southern Illinois University School of Medicine, Springfield, IL.
Urology, Memorial Sloan Kettering Cancer Center, New York, NY.
Urology. 2016 Sep;95:128-31. doi: 10.1016/j.urology.2016.05.014. Epub 2016 May 25.
To describe the pathologic findings and clinical outcome data for patients undergoing pelvic lymph node dissection (PLND) in the course of management of testicular germ cell tumors at Memorial Sloan Kettering Cancer Center (MSKCC).
Following institutional review board approval, data on 2186 patients who underwent retroperitoneal lymph node dissection (RPLND) at MSKCC between 1989 and 2011 were retrospectively reviewed. Of these 2186 patients, we analyzed data for 44 patients (2%) who underwent PLND at the time of RPLND.
PLND was performed in 14/44 (31%) patients at time of primary RPLND (P-RPLND), and in 21/44(48%) patients at time of postchemotherapy RPLND (PC-RPLND), usually for suspicious radiologic or intraoperative findings, whereas 9/44 (21%) underwent PLND for treatment of relapse. Positive pelvic findings on imaging included pelvic disease ≤5 cm in 17/44 (39%) patients and >5 cm in 11/44 (25%) patients (median size = 4 cm). At the time of PC-RPLND, alpha-fetoprotein and beta human chorionic gonadotropin were elevated in 6/21 (29%) and 4/21 (19%) patients, respectively. Histology revealed teratoma in 15/44 (34%) and viable tumor in 5/44 (11%) patients. At a median follow-up of 46 months, 40/44 (91%) patients were living without disease, 3/44 (7%) were living with disease (1 after PC-RPLND and 2 after relapse), and 1/44 (2%) died of other causes.
PLND was performed infrequently in our series of patients who underwent RPLND for testis cancer. Teratoma was the dominant tumor histology in the resected tissue.
描述在纪念斯隆凯特琳癌症中心（MSKCC）接受睾丸生殖细胞肿瘤治疗过程中进行盆腔淋巴结清扫术（PLND）的患者的病理结果和临床结局数据。
经机构审查委员会批准，对1989年至2011年间在MSKCC接受腹膜后淋巴结清扫术（RPLND）的2186例患者的数据进行回顾性分析。在这2186例患者中，我们分析了44例（2%）在RPLND时接受PLND的患者的数据。
14/44（31%）例患者在初次RPLND（P-RPLND）时进行了PLND，21/44（48%）例患者在化疗后RPLND（PC-RPLND）时进行了PLND，通常是因为可疑的影像学或术中发现，而9/44（21%）例患者因复发治疗接受PLND。影像学检查发现盆腔阳性结果包括17/44（39%）例患者盆腔病变≤5 cm，11/44（25%）例患者>5 cm（中位大小=4 cm）。在PC-RPLND时，分别有6/21（29%）和4/21（19%）例患者甲胎蛋白和β人绒毛膜促性腺激素升高。组织学检查显示15/44（34%）例患者为畸胎瘤，5/44（11%）例患者为存活肿瘤。中位随访46个月时，40/44（91%）例患者无病存活，3/44（7%）例患者带病存活（1例在PC-RPLND后，2例在复发后），1/44（2%）例患者死于其他原因。
在我们这组接受睾丸癌RPLND的患者中，PLND的实施并不常见。畸胎瘤是切除组织中的主要肿瘤组织学类型。
