1998
From: American Urological Association
Is RLND Alone Optimal Or Sufficient Thereapy For Clincial Stage 1 NSGCTT At High Risk For Relapse? Patients with clinical stage 1 nonseminomatous germ cell testicular cancer often are at risk for disease relapse. In 1989, this group of researchers began to perform retroperitoneal lymph node dissection (RLND) as therapy on these high risk patients. Out of 25 men, the procedure revealed metastases in the nodes of only 7. Yet 11 patients relapsed. Among this group were 4 of the 7 who had positive lymph nodes and 7 of 19 with negative lymph nodes. All those who relapsed received chemotherapy. According to the investigators, only 3 patients with positive lymph nodes did not relapse (at approximately 5 years followup). These individuals were considered potentially cured by RLND. The researchers said that the 12 patients with negative lymph nodes who had not relapsed to date (average of 55 months followup) were apparently cured by surgical removal of one or both testes. The investigators' data showed that RLND alone is not the answer. Close followup for this type of cancer is mandatory since 42% of these patients did relapse. These researchers are currently investigating whether 2 courses of preemptive chemotherapy instead of RLND might successfully kill hidden cancer cells in the lymph nodes and elsewhere in the body.
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