Retroperitoneal lymph node dissection and ejaculation disorders in patients with testicular nonseminomatous germ cell tumours

Česká verzia

Authors: J. Jarabák ¹; R. Zachoval ¹; J. Abrahámová ²; Z. Donátová ²
Authors place of work: Urologické oddělení Primář: doc. MUDr. Roman Zachoval, Ph. D. ¹; Onkologické oddělení Primář: prof. MUDr. Jitka Abrahámová, DrSc. Fakultní Thomayerova nemocnice s poliklinikou ²
Published in the journal: Prakt. Lék. 2009; 89(3): 143-146
Category: Therapy

Summary

Multimodal treatment strategies in the treatment of testicular nonseminomatous germ cell tumours (NSGCT) may include surveillance, chemotherapy and/or retroperitoneal lymph node dissection (RPLND). RPLND is associated with a relatively high rate of complications such as ejaculation disorders and, as a consequence, has ceded its dominant role in the therapy of NSGCT to chemotherapy. However, with the development of novel laparoscopic techniques, modified and nerve-sparing RPLND is becoming increasingly popular. The long-term tumour control achieved by the procedure in suitable patients is comparable to that in classical RPLND but the incidence of complications, including ejaculatory dysfunction, is significantly reduced. It is doubtful whether nerve-sparing techniques can be reliably applied for the technically demanding salvage RPLND procedures, which are a key part of treatment of advanced NSGCT.

Key words:
retroperitoneal lymphadenectomy, ejaculatory function, nonseminomatous germ cell tumour.

Zdroje

1. Jewett, M.A., Kang, Y., Goldberg, S.D. et al. Retroperitoneal lymphadenectomy for testis tumor with nerve sparing for ejaculation. J. Urol. 1988, 139, p. 1220-1224.

2. Donohue, J.P., Foster, R.S., Rowland, R.G. et al. Nerve-sparing retroperitoneal lymphadenectomy with preservativ of ejaculation. J. Urol. 1993, 144, p. 287-292.

3. Pizzocaro, G. Retroperitoneal lymphadenectomy in clinical stage I nonseminomatous germinal testis cancer. Eur. J. Surg. Oncol. 1986, 12, p. 25-28.

4. Foster, R.S. Modified retroperitoneal lymphadenectomy. BJU Int. 2004, 94, p. 941-955.

5. Arruda, H.O., Paula, P., Suarez, R. et al. Can selective retroperitoneal lymphadenectomy by better than unilateral retroperitoneal lymhadenectomy? Inter. Braz. J. Urol. 2003, 29, p. 412-417.

6. Magelssen, H., Brydoy, M., Fossa, D.S. The effects of cancer and cancer treatments on male reproductive function. Nat. Clin. Pract. Urol. 2006, 3(6), p. 312-322.

7. Fossa, S.D., Kleep, O., Ous, S. et al. Unilateral retroperitoneal lymf node dissecton in patiens with nonseimonomaotus testicular tumor in clinical stage I. Eur. Urol. 1984, 10, p. 17-23.

8. Klein, E.A. Open technique for nerve-sparing retroperitoneal lymphadenectomy. Urology 2000, 55, p. 132-135.

9. Baniel, J., Foster, R.S., Rowland, R.G. et al. Complications of primary retroperitoneal lymph node dissection. J. Urol. 1994, 152, p. 424-427.

10. Janetscheck, G., Hobish, A., Hotl, L. et al. Retroperitoneal lymphadenectomy for clinical stage I nonseminomatous testicular tumor: laparoscopy versus oper surgery and impact of learning curve. J. Urol. 1996, 156(1), p. 89-93.

11. Argirovic, D., Hadzi-Djokic, J., Micic, S. Quality of life after retroperitoneal lymphadenectomy in low clinical stages of nonseminomatous testicular tumors. Acta Chir. Iugosl. 1999, 46(1), p. 31-33.

12. Castelli, E., Terrone, C., De Lucca, S. et al. Retroperitoneal lymphadenectomy for testicular cancer and genito-sexual conditions: retrospective study. Prog. Urol. 2000, 10(4), p. 578-582.

13. Heidenreich, A., Albers, P., Hartmann, M. et al. Complications of primary nerve sparing retroperitoneal lymph node dissection for clinical stage I nonseminomatous germ cell tumors of the testis: experience of the german testicular cancer study group. J. Urol. 2003, 169, p. 1710-1714.

14. Castillo, A.O., Alvarez, M.J., Vitagliano, G. et al. Linfadenectomia retroperitoneal laparoscopica en cancer de testiculo no seminoma estadio I. Arch. Esp. Urol. 2007, 60(1), p. 59-66.