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Advances in Urology
Volume 2018 (2018), Article ID 7978958, 5 pages
https://doi.org/10.1155/2018/7978958
Review Article

Retroperitoneal Lymph Node Dissection as Primary Treatment for Metastatic Seminoma

1Department of Urology, Loma Linda University, 11234 Anderson Street Room A-560, Loma Linda, CA 92374, USA
2University of Southern California Institute of Urology, 1441 Eastlake Avenue, Los Angeles, CA 90033, USA

Correspondence should be addressed to Brian Hu; moc.liamg@08uh.nairb

Received 2 October 2017; Accepted 13 December 2017; Published 1 February 2018

Academic Editor: Aditya Bagrodia

Copyright © 2018 Brian Hu and Siamak Daneshmand. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Reducing the long-term morbidity in testicular cancer survivors represents a major area of interest. External beam radiation therapy and systemic chemotherapy are established treatments for seminoma; however, they are associated with late toxicities such as cardiovascular disease, insulin resistance, and secondary malignancy. Retroperitoneal lymph node dissection (RPLND) is a standard treatment for nonseminomatous germ cell tumors (NSGCT) that has minimal long-term morbidity. Given the efficacy of RPLND in management of NSGCT, interest has developed in this surgery as a front-line treatment for seminoma with isolated lymph node metastasis to the retroperitoneum. Four retrospective studies have shown promising results when surgery is performed for seminomas with low-volume retroperitoneal metastases. To better determine if RPLND can be recommended as a primary treatment option, two prospective clinical trials (SEMS and PRIMETEST) are underway. This review will examine the literature, discuss the benefits/limitations of RPLND, and compare the methodologies of the two ongoing clinical trials.