Cervical lymph node dissection for metastatic testicular cancer

M. G. Van Vledder, J. A. Van Der Hage, W. J. Kirkels, J. W. Oosterhuis, C. Verhoef, J. H.W. De Wilt

Onderzoeksoutput: Bijdrage aan tijdschriftArtikelpeer review

22 Citaten (Scopus)


Introduction. Despite high response rates to systemic chemotherapy, 30% of patients with advanced stage testicular carcinoma will have extra- retroperitoneal residual masses that require resection. Most often, these are located in the lungs and mediastinum and neck. Limited data are available concerning the incidence, surgical management, and follow-up of neck metastasis arising from a testicular primary tumor. Methods. We retrospectively reviewed all 665 patients who were referred to a tertiary referral center with the diagnosis of testicular cancer from January 1997 to June 2009 for the presence of cervical metastases. Patients who underwent concomitant surgical therapy were identified and analyzed. Clinical and pathological data were collected from patient records, including radiology and pathology reports. Furthermore, data on primary treatment strategy, chemotherapeutic regimens, timing of surgical procedures, complications, disease recurrence, and follow-up were collected. Results. Twenty-six patients (4%) had cervical lymph node metastasis. The majority (n = 19) had multiple ERP sites. Nine patients (35%) underwent selective neck dissection: in six patients, this was indicated because of residual masses after chemotherapy, and in three patients, cervical masses represented a late and distant relapse of previously treated disease. Viable cancer cells were present in the resected specimen only in these three patients. Seven patients are currently without evidence of disease. Two patients died of disseminated disease. Conclusions. Cervical lymph node metastases originating from testicular cancer are rare but are more commonly observed in patients with advanced stage disease. Selective neck dissection can be safely performed both after chemotherapy and in the case of recurrent disease.

Originele taal-2Engels
Pagina's (van-tot)1682-1687
Aantal pagina's6
TijdschriftAnnals of Surgical Oncology
Nummer van het tijdschrift6
StatusGepubliceerd - jun. 2010
Extern gepubliceerdJa


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