A.V. Sakalo, C.V. Bazalitskaya, Yu.N. Bondarenko, V.V. Mrachkovckiy, V.A. Kropelnitskiy, V.S. Sakalo

Modified retroperitoneal lym­phadenectomy with metastatic non­seminomatous testicular germ cell tumors

Retroperitoneal lymph node removal zone still remains controversial in patients with non-semino­matous germ cells tumors (NGT) after induction chemotherapy. We observed 46 patients with NGT, whom the removal of residual tumors had been made after systemic chemotherapy. A modified lymph node dissection (LND) was performed for all patients with clinically diagnosed metastases in the retroperitoneal area in the zone of the location of metastases according to the tumor’s characteristics of right and left testicle, as well as the size of residual tumor <5cm in diameter. We found 42.6% of non-specific fibrosis, 36.9% of mature teratoma and 25% - a viable tumor. Antegrade ejaculation is preserved in 76% of patients after modified LND. There were two patients (4%) observed with local recurrence. It is possible to perform a modified RLND for patients with clearly visualized residual tumor, which in most cases maintains antegrade ejaculation without worsening the survival.