Laparoscopic Retroperitoneal Lymph Node Dissection After Chemotherapy for Nonseminomatous Testicular Germ-Cell Tumor at a Single Center

Abstract

Objective: This study investigated the perioperative and oncological outcomes of laparoscopic retroperitoneal lymph node dissection (RPLND) procedures for post-chemotherapy patients with nonseminomatous testicular germ-cell tumor at a single center.

Methods: This study included patients with nonseminomatous testicular cancer who underwent RPLND after chemotherapy at the Kyushu University Hospital between 2016 and 2024. The preoperative clinicopathological characteristics, perioperative outcomes, and oncological outcomes were investigated.

Results: A total of 13 patients underwent laparoscopic RPLND. Median maximum retroperitoneal tumor size at post-chemotherapy before RPLND was 11 mm (range, 2-30 mm). RPLND template was one side and both sides in nine and four patients. Median operative time was 272 min (range, 129-490 min), and median estimated blood loss was 27 mL (range, 0-100 mL). Median time from operation to discharge was 8 days (range, 5-15 days). There was no severe perioperative and postoperative complication. Residual cancer and teratoma were detected in one and seven patients. During median follow-up of 18.6 months (range, 1.0-95.7 months), no case presented recurrence.

Conclusion: Laparoscopic RPLND presented safety in perioperative outcomes and favorable oncological outcomes. Thus, it was confirmed that laparoscopic RPLND is a feasible minimally invasive procedure for selected cases.

Keywords: laparoscopy; nonseminomatous germ‐cell tumor; post‐chemotherapy; retroperitoneal lymph node dissection; testicular cancer.