Hedienreich Criteria for Retroperitoneal Lymph Node Dissection for Post-Chemotherapy Residual Masses in a Patient with Nonseminomatous Germ Cell Tumor of the Testis
While most patients with advanced testicular cancer require bilateral retroperitoneal lymph node resection after chemotherapy, selected patients can undergo a modified resection. This can reduce morbidity without affecting prognosis. The authors are from the University of Cologne and Klinikum Kassel GmbH in Germany.
Patient selection: advanced testicular cancer, status post chemotherapy, with residual retroperitoneal masses
Criteria for modified template resection:
(1) prechemotherapy location of the residual mass is in the landing zone of the tumor-bearing testicle
(2) residual mass <= 5 cm (exception: some cases of well-delineated teratoma)
(3) does not meet criteria for radical template resection
Criteria for radical template resection:
(1) contralateral spread
(2) interaortocaval location
(3) residual mass > 5 cm
Mature teratoma was present in all patients with elevated but plateauing AFP levels.
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