The current status of laparoscopic RPLND for non-seminomatous germ-cell tumors

[Karen]

Retroperitoneal lymph node dissection (RPLND) is used in both the staging and management of non-seminomatous germ-cell tumors. Although a number of advantages of the laparoscopic approach have been reported over open RPLND, its use has not been supported by formal internal review board-approved studies. Brett Carver and Joel Sheinfeld discuss RPLND in the management of these tumors, both before and after chemotherapy.


Carver BS, Sheinfeld J.
Department of Urology, Memorial Sloan-Kettering Cancer Center, New York, USA

http://www.nature.com/ncpuro/journal/v2/n7/full/ncpuro0226.html

An appropriately performed retroperitoneal lymph node dissection (RPLND) is both a diagnostic and a therapeutic procedure in the management of non-seminomatous germ-cell tumors. In an attempt to minimize the morbidity associated with an open RPLND, several investigators have evaluated the role of laparoscopic RPLND. Laparoscopic RPLND is technically feasible in the hands of dedicated experts, and results in a reduced hospital stay, operative blood loss, and post-operative morbidity compared to open RPLND. Currently, however, none of the reports in the literature have adequately evaluated the therapeutic efficacy of laparoscopic RPLND, as the vast majority of patients are treated with adjuvant chemotherapy regardless of the risk of systemic relapse. Future prospective internal review board-approved trials need to be developed to evaluate the therapeutic efficacy of laparoscopic RPLND, with careful observation of patients with pathologic low-volume nodal disease.
Nat Clin Pract Urol. 2005 Jul;2(7):330-5.

[Hopeful]

Anothe link to it is www.pubmed.gov.

also use clinicaltrials.gov