Post-chemotherapy retroperitoneal lymph node dissection in the management of metastatic XXXX : the 16-year experience in an Irish setting.

@entity5 @entity1 @entity44 @entity4797
INTRODUCTION: Post-chemotherapy retroperitoneal lymph node dissection (PC-RPLND) is an important tool in the management of advanced germ cell @entity5 , @entity4797 . AIM: We present the 16-year experience with PC-RPLND in a single Irish tertiary referral centre, and compare our results to the major speciality centres worldwide. METHODOLOGY: All 78 @entity1 undergoing PC-RPLND for the treatment of metastatic @entity5 between January 1996 and December 2011 were included. Medical records were reviewed and up to date follow-up obtained from primary referral centres, @entity1 's GPs and individual @entity1 interview. RESULTS: The mean age at diagnosis was 28.5      7  years. Initial pathology included @entity4797 62.8  %, @entity4797 6.4  % and combined 19.2  %. All @entity1 underwent pre-operative chemotherapy. The resection template utilised was bilateral infra-hilar in 29.5  %, unilateral  infra-hilar in 46.2  % and supra-hilar in 20.5  %. Complete abdominal remission was achieved in all but one @entity1 . Additional procedures were required in 38.5  % of @entity1 (n  =  30). Clavien Dindo grade three or four complications were seen in 8.9  %, including five @entity1 who required early reoperation. Histology of RPLND specimen showed mature @entity44 (41  %) and active @entity5 (11.5  %). Follow-up data were available for 66 @entity1 (85  %). Median follow-up was 101 (11-207) months. Nine @entity1 relapsed with median time to relapse 15 (8-60) months. Overall 5-year survival rate was 95.2  % (four deaths). CONCLUSION: In this relatively small series due to small population and low disease incidence, we have shown acceptable peri-operative course, morbidity and oncological outcomes with PC-RPLND compared to major international centres.
