Abstract | PURPOSE: MATERIALS AND METHODS: Patients who had undergone retroperitoneal lymph node dissection at our institution from 1993 to 2009 were identified and clinical charts were reviewed. A total of 90 patients with orchiectomy specimens containing more than 30% embryonal carcinoma who underwent primary retroperitoneal lymph node dissection were identified and perioperative data were obtained. RESULTS: Of 353 patients 90 (25%) had greater than 30% embryonal carcinoma and underwent primary retroperitoneal lymph node dissection. Of these patients 45 (50%) had lymphovascular invasion. Median followup was 1.1 years. Positive lymph nodes identified at retroperitoneal lymph node dissection were noted in 30 (46%) and 15 (60%) patients with clinical stage I vs clinical stage II disease. On multivariate analysis embryonal carcinoma (OR 1.02, 95% CI 1.00-1.04) and lymphovascular invasion (OR 3.52, 95% CI 1.43-8.67) were associated with positive lymph nodes at retroperitoneal lymph node dissection. The positive predictive value for 100% embryonal carcinoma was 65.5%, although the negative predictive value for 30% embryonal carcinoma was 85.7%. CONCLUSIONS:
Embryonal carcinoma and lymphovascular invasion were significantly and independently associated with the risk of occult retroperitoneal metastatic disease. These results should be considered when counseling patients about appropriate treatment options.
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Authors | S B Williams, R Kacker, D Winston, E Bahnson, G S Steele, J P Richie |
Journal | The Journal of urology
(J Urol)
Vol. 186
Issue 6
Pg. 2245-8
(Dec 2011)
ISSN: 1527-3792 [Electronic] United States |
PMID | 22014805
(Publication Type: Journal Article)
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Copyright | Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved. |
Topics |
- Adult
- Humans
- Lymphatic Metastasis
- Male
- Neoplasm Staging
- Neoplasms, Germ Cell and Embryonal
(secondary, surgery)
- Predictive Value of Tests
- Retroperitoneal Space
- Risk Factors
- Testicular Neoplasms
(pathology, surgery)
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