Department of Urology, Gulhane Research and Training Hospital, Ankara, Turquía.
Department of Urology, Cukurca State Hospital, Hakkari, Turquía.
Actas Urol Esp (Engl Ed). 2021 Jan-Feb;45(1):30-38. doi: 10.1016/j.acuro.2020.03.014. Epub 2020 Oct 1.
In this retrospective study, we aimed to evaluate lymph node (LN) density in retroperitoneal lymph node dissection (RPLND) to analyze whether residual mass after chemotherapy might behave as predicting factor for recurrence in patients with germ cell testicular cancer (GCTC).
The data of 185 patients that were operated between 12/2004 and 02/2017 because of GCTC were reviewed retrospectively. LN density was calculated. The patients were compared statistically in terms of demographic features, tumor characteristics, serum tumor marker levels, treatment strategies, and pathological results according to GCTC subtypes. Correlation analysis was performed to determine the parameters related to recurrent disease.
The median follow-up was 79 (31-179) months and the median age of the patients was 23 (16-71). The median tumor size was 4 (1-18) cm. Five (2.7%) patients had metastatic disease at initial diagnosis. Seminoma, non-seminomatous-GCT and mix type-GCTC was detected in 62 (33.5%), 60 (32.4%) and 63 (34.1%) patients, respectively. Following inguinal orchiectomy, 48 (25.9%) patients underwent follow-up, 126 (68.1%) patients underwent chemotherapy and 11 (5.9%) patients underwent radiotherapy. A total of 21 (11.4%) patients underwent post-chemotherapy RPLND. Early and late recurrence was seen in 3 (1.6%) and 2 (1.1%) of the patients, respectively. A mild to moderate, negative, but significant correlation was found between the recurrence and the number of LNs containing metastatic deposits and LN density (r= -0.490, P=.024 and r= -0.450, P=.041, respectively).
There was a negative correlation between the number of LNs containing metastatic deposits and LN density and recurrent disease.
在这项回顾性研究中，我们旨在评估腹膜后淋巴结清扫术（RPLND）中的淋巴结（LN）密度，以分析化疗后残留肿块是否可能成为精原细胞瘤睾丸癌（GCTC）患者复发的预测因素。
回顾性分析了 2004 年 12 月至 2017 年 2 月期间因 GCTC 而接受手术的 185 例患者的数据。计算了 LN 密度。根据 GCTC 亚型，对患者的人口统计学特征、肿瘤特征、血清肿瘤标志物水平、治疗策略和病理结果进行统计学比较。进行相关性分析以确定与复发病相关的参数。
中位随访时间为 79 个月（31-179 个月），患者的中位年龄为 23 岁（16-71 岁）。肿瘤大小中位数为 4cm（1-18cm）。5 例（2.7%）患者初诊时即有转移病灶。分别在 62 例（33.5%）、60 例（32.4%）和 63 例（34.1%）患者中发现精原细胞瘤、非精原细胞瘤-GCT 和混合-GCTC。行腹股沟睾丸切除术后继行随访的患者有 48 例（25.9%），接受化疗的患者有 126 例（68.1%），接受放疗的患者有 11 例（5.9%）。共有 21 例（11.4%）患者接受了化疗后 RPLND。患者中分别有 3 例（1.6%）和 2 例（1.1%）发生早期和晚期复发。复发与含转移灶的淋巴结数量和 LN 密度之间存在轻度至中度、阴性但显著的相关性（r=-0.490，P=0.024 和 r=-0.450，P=0.041）。
含转移灶的淋巴结数量和 LN 密度与复发病之间存在负相关。
