Retroperitoneal Lymph Node Dissection as First-Line Treatment of Node-Positive XXXX .

@entity1 @entity3329 @entity137 @entity2971 @entity5 @entity1600 @entity1442 @entity4797 @entity204
INTRODUCTION: The long-term morbidity associated with treating @entity1442 can be significant. @entity1600 ( @entity1600 ) has established oncologic efficacy in treating @entity2971 with minimal long-term @entity137 . We describe our experience with @entity1600 as a front-line treatment of lymph node-positive @entity4797 . MATERIALS AND METHODS: We reviewed our institutional review board-approved @entity5 database to find the @entity1 with pure @entity4797 and isolated @entity1600 who had undergone primary @entity1600 . The clinical and pathologic variables were obtained. The follow-up data were used to determine recurrence and @entity204 . RESULTS: Four @entity1 with a mean age of 37 years were identified. All @entity1 had normal @entity5 markers and @entity3329 measuring 1.1, 1.5, 1.8, and 5.5 cm before @entity1600 . Of the 4 @entity1 , 3 had had @entity4797 diagnosed at orchiectomy and 1 (with a 5.5-cm @entity3329 and a burned out primary testicular mass) had had @entity4797 diagnosed at @entity1600 after 2 nondiagnostic retroperitoneal biopsies. All @entity1 had undergone nerve-sparing, template, extraperitoneal @entity1600 and were discharged home after 3 days. An average of 3 positive lymph nodes were found. Of the 4 @entity1 , 3 had pathologic stage IIA and 1 stage IIB disease, with no @entity1 undergoing adjuvant therapy. At a mean follow-up period of 25 months, no @entity1 had experienced disease recurrence, and none had died. All @entity1 maintained antegrade ejaculation, and no long-term complications had developed. CONCLUSION: Our small series has demonstrated encouraging oncologic efficacy for @entity1600 as a primary treatment of retroperitoneal lymph node-positive @entity4797 . A multi-institutional phase II trial of @entity1600 for stage @entity4797 is being developed.
