Yadav K
Max Institute of Cancer Care, Maxhealthcare, Gurgaon, Haryana, India.
Clin Transl Oncol. 2017 Jul;19(7):793-798. doi: 10.1007/s12094-017-1622-5. Epub 2017 Feb 1.
Management of testicular cancer has evolved through many breakthroughs. The decades of zeal to improve oncologic adequacy and to decrease morbidity has led to the current scientific knowledge of retroperitoneal lymph node dissection templates. Retroperitoneal lymph node dissection (RPLND) has potential for staging, prognostication and therapeutic importance in the management of testicular malignancy. RPLND has overcome limitations of current imaging which understage 30% of stage I disease and overstage 25-30% of stage II disease. For low-volume disease, RPLND is curative in up to 90% cases without adjuvant therapy and has important role in postchemotherapy residual disease. Risk of recurrence after RPLND is 1% and follow-up imaging can be limited, thus avoiding their potential risk of radiation exposure. RPLND reveals vital information of disease nature and guide adjuvant therapy. Despite the long evolution period, certain controversies still surround RPLND. We aim to refine this challenging management in the following manuscript based on available evidence.
睾丸癌的管理已经历了许多突破而不断演变。数十年来，人们热衷于提高肿瘤治疗的充分性并降低发病率，这促成了目前关于腹膜后淋巴结清扫模板的科学认知。腹膜后淋巴结清扫术（RPLND）在睾丸恶性肿瘤的管理中具有分期、预后评估及治疗方面的潜在重要性。RPLND克服了当前影像学的局限性，目前影像学对30%的I期疾病分期过低，对25 - 30%的II期疾病分期过高。对于低负荷疾病，RPLND在不进行辅助治疗的情况下，高达90%的病例可治愈，并且在化疗后残留疾病的治疗中发挥重要作用。RPLND术后复发风险为1%，后续影像学检查可受到限制，从而避免其潜在的辐射暴露风险。RPLND能揭示疾病性质的关键信息并指导辅助治疗。尽管经历了漫长的演变过程，但RPLND仍存在某些争议。我们旨在基于现有证据，在以下手稿中完善这一具有挑战性的管理方法。
