腹腔镜切除晚期非精原细胞瘤性生殖细胞肿瘤残留腹膜后肿瘤；一种可行且安全的肿瘤学方法。
Laparoscopic Resection of Residual Retroperitoneal Tumor Mass in Advanced Nonseminomatous Testicular Germ Cell Tumors; a Feasible and Safe Oncological Procedure.
机构信息
Department of Surgical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
出版信息
Sci Rep. 2019 Nov 1;9(1):15837. doi: 10.1038/s41598-019-52109-5.
Ten-year oncological experience of the University Medical Center Groningen with conventional laparotomy (C-RRRTM) and laparoscopy (L-RRRTM) is described concerning resection of residual retroperitoneal tumor masses (RRTM) in a large series of patients with advanced nonseminomatous testicular germ cell tumors (NSTGCT). 150 consecutive patients with disseminated NSTGCT required adjunctive surgery after combination chemotherapy. L-RRRTM was scheduled in 89 and C-RRRTM in 61 patients. Median residual tumor diameter was 20 mm in the L-RRRTM versus 42 mm in the C-RRRTM group (p < 0.001). Conversion rate was 15% in the L-RRRTM group. Perioperative complications occurred in 5 patients (6%) in the L-RRRTM and 7 (12%, NS) in the C-RRRTM group. Median duration of L-RRRTM was 156 minutes vs. 221 minutes for C-RRRTM (p < 0.001). 17/89 patients in the L-RRRTM group had postoperative complications versus 18/61 patients in the C-RRRTM group (NS). Median postoperative stay in the L-RRRTM group was 2 vs. 6 days in the C-RRRTM group (p < 0.001). During a median follow-up of 79 months, 27 patients had recurrences: 8 (9%) in the L-RRRTM group and 19 (31%) in the C-RRRTM group (p < 0.001). Laparoscopic resection of RRTM for advanced NSTGCT is feasible and an oncologically safe option in appropriately selected patients.
本文描述了格罗宁根大学医学中心在常规剖腹手术（C-RRRTM）和腹腔镜手术（L-RRRTM）方面的十年肿瘤学经验，涉及对晚期非精原细胞瘤生殖细胞肿瘤（NSTGCT）患者进行残余腹膜后肿瘤（RRTM）切除术。150 例播散性 NSTGCT 患者在联合化疗后需要辅助手术。89 例患者计划行 L-RRRTM，61 例行 C-RRRTM。L-RRRTM 组的中位残余肿瘤直径为 20mm，C-RRRTM 组为 42mm（p<0.001）。L-RRRTM 组的转化率为 15%。L-RRRTM 组有 5 例（6%）和 C-RRRTM 组有 7 例（12%，无统计学差异）发生围手术期并发症。L-RRRTM 的中位手术时间为 156 分钟，C-RRRTM 为 221 分钟（p<0.001）。L-RRRTM 组有 17/89 例患者术后发生并发症，C-RRRTM 组有 18/61 例（无统计学差异）。L-RRRTM 组的中位术后住院时间为 2 天，C-RRRTM 组为 6 天（p<0.001）。在中位随访 79 个月期间，27 例患者复发：L-RRRTM 组 8 例（9%），C-RRRTM 组 19 例（31%）（p<0.001）。对于晚期 NSTGCT，腹腔镜切除 RRTM 是可行的，并且是在适当选择的患者中一种具有肿瘤学安全性的选择。
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