Laparoscopic Resection of Residual Retroperitoneal Tumor Mass in Advanced Nonseminomatous Testicular Germ Cell Tumors; a Feasible and Safe Oncological Procedure

• Published in: Scientific reports Vol. 9; no. 1; pp. 15837 - 10
• Main Authors: Öztürk, Çiğdem, Been, Lukas B., van Ginkel, Robert J., Gietema, Jourik A., Hoekstra, Harald J.
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.11.2019; Nature Publishing Group
• Subjects: 692/308/409; 692/4025/1679; 692/4028/546; Adolescent; Adult; Aged; Chemotherapy; Gastric cancer; Humanities and Social Sciences; Humans; Laparoscopy; Laparotomy; Male; Middle Aged; multidisciplinary; Neoplasm Recurrence, Local - epidemiology; Neoplasm Recurrence, Local - pathology; Neoplasm Recurrence, Local - surgery; Neoplasm, Residual; Neoplasms, Germ Cell and Embryonal - epidemiology; Neoplasms, Germ Cell and Embryonal - pathology; Neoplasms, Germ Cell and Embryonal - surgery; Patients; Retroperitoneal Neoplasms - epidemiology; Retroperitoneal Neoplasms - pathology; Retroperitoneal Neoplasms - secondary; Retroperitoneal Neoplasms - surgery; Retrospective Studies; Science; Science (multidisciplinary); Surgery; Testes; Testicular Neoplasms - epidemiology; Testicular Neoplasms - pathology; Testicular Neoplasms - surgery; Time Factors; Tumors
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-019-52109-5

Ten-year oncological experience of the University Medical Center Groningen with conventional laparotomy (C-RRRTM) and laparoscopy (L-RRRTM) is described concerning resection of residual retroperitoneal tumor masses (RRTM) in a large series of patients with advanced nonseminomatous testicular germ cell tumors (NSTGCT). 150 consecutive patients with disseminated NSTGCT required adjunctive surgery after combination chemotherapy. L-RRRTM was scheduled in 89 and C-RRRTM in 61 patients. Median residual tumor diameter was 20 mm in the L-RRRTM versus 42 mm in the C-RRRTM group (p < 0.001). Conversion rate was 15% in the L-RRRTM group. Perioperative complications occurred in 5 patients (6%) in the L-RRRTM and 7 (12%, NS) in the C-RRRTM group. Median duration of L-RRRTM was 156 minutes vs. 221 minutes for C-RRRTM (p < 0.001). 17/89 patients in the L-RRRTM group had postoperative complications versus 18/61 patients in the C-RRRTM group (NS). Median postoperative stay in the L-RRRTM group was 2 vs. 6 days in the C-RRRTM group (p < 0.001). During a median follow-up of 79 months, 27 patients had recurrences: 8 (9%) in the L-RRRTM group and 19 (31%) in the C-RRRTM group (p < 0.001). Laparoscopic resection of RRTM for advanced NSTGCT is feasible and an oncologically safe option in appropriately selected patients.