Abstract：
Background and Objectives: The aim of this article is to present a single-surgeon, open retroperitoneal lymph node dissection (RPLND) series for testicular cancer in a high-volume center. Materials and Methods: We reviewed data from patients who underwent RPLND performed by an experienced surgeon at our institution between 2000 and 2019. We evaluated surgical and perioperative outcomes, complications, Recurrence-Free Survival (RFS), Overall Survival (OS), and Cancer-Specific Survival (CSS). Results: RPLND was performed in primary and secondary settings in 21 (32%) and 44 (68%) patients, respectively. Median operative time was 180 min. Median hospital stay was 6 days. Complications occurred in 23 (35%) patients, with 9 (14%) events reported as Clavien grade ≥ 3. Patients in the primary RPLND group were significantly younger, more likely to have NSGCT, had higher clinical N0 and M0, and had higher nerve-sparing RPLND (all p ≤ 0.04) compared to those in the secondary RPLND group. In the median follow-up of 120 (56-180) months, 10 (15%) patients experienced recurrence. Finally, 20-year OS, CSS, and RFS were 89%, 92%, and 85%, respectively, with no significant difference in survival rates between primary vs. secondary RPLND subgroups (p = 0.64, p = 0.7, and p = 0.31, respectively). Conclusions: Open RPLND performed by an experienced high-volume surgeon achieves excellent oncological and functional outcomes supporting the centralization of these complex procedures.
摘要：
背景和目的：本文的目的是介绍一个单一的外科医生，开放腹膜后淋巴结清扫术（RPLND）系列在高容量中心的睾丸癌。材料和方法：我们回顾了2000年至2019年间由我们机构经验丰富的外科医生进行RPLND的患者的数据。我们评估了手术和围手术期结果，并发症,无复发生存（RFS），总生存率（OS），癌症特异性生存（CSS）结果：在21例（32％）和44例（68％）患者的主要和次要设置中进行了RPLND，分别。中位手术时间为180分钟。平均住院时间为6天。23例（35%）患者出现并发症，9例（14%）事件报告为Clavien≥3级。原发性RPLND组患者明显年轻，更有可能有NSGCT，与继发性RPLND组相比，具有更高的临床N0和M0，并且具有更高的神经保留RPLND（所有p≤0.04）。在120(56-180)个月的中位随访中，10例（15%）患者经历了复发。最后,20年操作系统,CSS,RFS占89%，92%,85%,分别,原发性与原发性之间的生存率没有显着差异次级RPLND亚组（分别为p=0.64，p=0.7和p=0.31）。结论：由经验丰富的大量外科医生进行的开放式RPLND可实现出色的肿瘤和功能结果，支持这些复杂程序的集中化。
