临床I期非精原细胞瘤性睾丸肿瘤患者的单侧腹膜后淋巴结清扫术

Unilateral retroperitoneal lymph node dissection in patients with non-seminomatous testicular tumor in clinical stage I.

作者信息

Fosså S D, Klepp O, Ous S, Lien H H, Stenwig A E, Abyholm T, Kaalhus O

出版信息

Eur Urol. 1984;10(1):17-23. doi: 10.1159/000463504.

Abstract

19 of 53 patients (36%) with non-seminomatous testicular cancer, clinical stage I (CS I), had retroperitoneal lymph node metastases, pathological stage II (PS II), demonstrated by retroperitoneal lymph node dissection (RLND). RLND was done unilaterally in peroperatively tumor-free patients (PS I: 34 patients; PS II: 3 patients) and bilaterally if metastatic lymph nodes were found peroperatively. Patients with PS II received adjuvant cis-platinum containing combination chemotherapy. Postoperative tumor activity was observed in 3 patients (median observation time: 31 months). They were cured by salvage chemotherapy. 12-18 months after RLND no ejaculatory disturbances were observed in 28 of 36 unilaterally operated patients. After unilateral RLND, 7 patients fathered children. Unilateral RLND seems to be a sufficient diagnostic procedure in patients with non-seminomatous testicular cancer, CS I, who were found tumor-free during the operation. Fertility is preserved in the majority of the unilaterally operated patients.

摘要

53例临床I期（CS I）非精原细胞瘤性睾丸癌患者中，19例（36%）经腹膜后淋巴结清扫术（RLND）证实有腹膜后淋巴结转移，病理分期为II期（PS II）。对于术中未发现肿瘤的患者（PS I：34例；PS II：3例），RLND采用单侧手术；若术中发现转移性淋巴结，则采用双侧手术。PS II期患者接受含顺铂的辅助联合化疗。3例患者术后出现肿瘤活动（中位观察时间：31个月）。他们通过挽救性化疗治愈。RLND术后12 - 18个月，36例单侧手术患者中有28例未观察到射精障碍。单侧RLND后，7例患者生育了子女。对于术中未发现肿瘤的CS I期非精原细胞瘤性睾丸癌患者，单侧RLND似乎是一种充分的诊断方法。大多数单侧手术患者的生育能力得以保留。