RETROPERITONEAL LYMPHNODE DISSECTION IN TESTICULAR TUMORS

Abstract

As an additional treatment following radical orchiectomy in patients with non-seminomatous testi cular tumor, stages I and II, the retroperitoneal lymph node dissection has been generally employed in the U. S. A, and satisfactory results have been recently reported. On the contrary, it has been reported in Europe that satisfactory results have been obtained with postoperative radiotherapy alone.
Retroperitoneal lymph node dissection following radical orchiectomy is not yet popular in Japan and concerning its indication, the opinion of Japanese urologists is still diverse.
Clinical observations on cases with non-seminomatous testicular tumors have been done since 1962. In this paper, clinical study on 19 patients with retroperitoneal lymph node dissection following radical orchiectomy is reported.
In 13 out of the 19 cases, dissection was complete. However, in the remaining 6 cases, it was incomplete. In the 13 cases with complete dissection, the number of stage I and II were 7 and 6 cases, respectively. In all of the former cases, lymph node metastasis was not found histologically. However, in 3 out of the latter 6 cases, lymph node metastasis was demonstrated.
The 3 year survival rate in stage I and II with lymph node dissection was 83 and 100 per cent, respectively.
The 3 year survival rate in stage I without lymph node dissection was 90. 5 per cent.
As for the accuracy rate of preoperative lymphangiographic diagnosis, the false positive and negative rates were 43 and 0 per cent, respectively.
From the results above mentioned, it may be conjectured that in cases with stage I non-seminomatous testicular tumor, radical orchiectomy plus retroperitoneal radiation therapy alone may obtain satisfact ory results. However, in cases with questionable lymphangiographic findings, retroperitoneal lymph node dissection should be performed following radical orchiectomy.