Details

Autor(en) / Beteiligte

• Blok, Joost M.
• Meijer, Richard P.
• van der Poel, Henk G.
• Bex, Axel
• van Vooren, Jeanette
• van Urk, Japke J.
• Horenblas, Simon
• Bosch, J. L. H. Ruud

Titel

Additional surgical procedures and perioperative morbidity in post-chemotherapy retroperitoneal lymph node dissection for metastatic testicular cancer in two intermediate volume hospitals

Ist Teil von

• World journal of urology, 2021-03, Vol.39 (3), p.839-846

Ort / Verlag

Berlin/Heidelberg: Springer Berlin Heidelberg

Erscheinungsjahr

2021

Link zum Volltext

Quelle

SpringerLink (Online service)

Beschreibungen/Notizen

• Purpose To evaluate the perioperative morbidity of PC-RPLND in two intermediate volume centers and to identify predictors of high morbidity. Methods Retrospective analysis of 124 patients treated with open PC-RPLND at two tertiary referral centers between 2001 and 2018. Perioperative morbidity was determined by analyzing additional surgical procedures, intra-operative blood loss, and postoperative complications. Results An additional procedure was necessary for 33 patients (26.6%). The risk was higher in patients with IGCCCG intermediate/poor prognosis (OR 3.56; 95% CI 1.33–9.52) and residual tumor size > 5 cm (OR 3.53; 95% CI 1.39–8.93). Blood loss was higher in patients with IGCCCG intermediate/poor prognosis ( β =  0.177; p =  0.029), large residual tumor ( β =  0.570; p  < 0.001), an additional intervention ( β =  0.342; p  < 0.001) and teratoma on retroperitoneal histology ( β =  − 0.19; p =  0.014). Thirty-one patients had a postoperative complication Clavien-Dindo Grade ≥ 2 (25.0%). Complication risk was highest in patients undergoing an additional intervention (OR 3.46; 95% CI 1.03–11.60; p =  0.044). Conclusions The rate of additional interventions in our series is comparable to what has been reported in high-volume centers. IGCCCG intermediate/poor prognosis patients with high-volume disease and patients undergoing an additional surgical procedure can be classified as high-risk patients.