Otto T, Goepel M, Seeber S, Rübben H
Urologische Klinik und Poliklinik, Universitätsklinikum Essen.
Urologe A. 1993 May;32(3):189-93.
Retroperitoneal lymphadenectomy was performed in 462 patients with testicular cancer. A total of 142 patients with advanced non-seminomatous germ cell tumours underwent retroperitoneal lymphadenectomy following cisplatin-based polychemotherapy. After inductive chemotherapy all of the patients described (108/142) showed seroconversion of tumour markers. Histology following RLA revealed vital tumour in 41% and teratoma in 12%. It was not possible to distinguish preoperatively between non-malignant residual tissue and vital tumour. In addition, sonography, computed tomography, and the tumour marker results did not correlate significantly with the intraoperative histopathological findings. Although histopathological confirmed complete remission was achieved in 47% of the patients with chemotherapy alone, subsequent retroperitoneal lymphadenectomy remains mandatory in cases with residual retroperitoneal lesions and pathological partial remission.
462例睾丸癌患者接受了腹膜后淋巴结清扫术。142例晚期非精原细胞性生殖细胞肿瘤患者在接受以顺铂为基础的多药化疗后进行了腹膜后淋巴结清扫术。诱导化疗后，所有上述患者（108/142）的肿瘤标志物均出现血清学转化。腹膜后淋巴结清扫术后的组织学检查显示，41%为存活肿瘤，12%为畸胎瘤。术前无法区分非恶性残留组织和存活肿瘤。此外，超声、计算机断层扫描和肿瘤标志物结果与术中组织病理学发现无显著相关性。尽管单纯化疗的患者中有47%经组织病理学证实达到完全缓解，但对于有腹膜后残留病变和病理部分缓解的病例，后续的腹膜后淋巴结清扫术仍然是必要的。
