{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T18:16:24Z","timestamp":1777918584022,"version":"3.51.4"},"reference-count":20,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2022,8,1]],"date-time":"2022-08-01T00:00:00Z","timestamp":1659312000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Tumori"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Patients with stage II germ-cell tumours (GCT) usually undergo radiotherapy (seminoma only) or chemotherapy. Both strategies display a recognised risk of long-term side effects. We evaluated retroperitoneal lymph node dissection (RPLND) as exclusive treatment in stage II GCT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Between 2008 and 2019 included, 66 selected stage II GCT patients underwent primary open (O-) or laparoscopic (L-)RPLND. Type of procedure and extent of dissection, operative time, node rescue, hospital stay, complications (according to Clavien-Dindo), administration of chemotherapy, relapse and site of relapse were evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Five patients had pure testicular seminoma. Nineteen (28.8%) had raised markers prior to RPLND; 48 (72.7%), 16 (24.2%) and two (3.0%) were stage IIA, IIB and IIC, respectively. O-RPLND and unilateral L-RPLND were 36 and 30 respectively. Six stage II A patients (12.5%) had negative nodes. Four patients underwent immediate adjuvant chemotherapy. One patient was lost at follow-up. After a median follow-up of 29 months, 48 (77.4%) of the 62 patients undergoing RPLND alone remained recurrence-free; one patient had an in-field recurrence following a bilateral dissection. According to procedure, number of rescued nodes (O-RPLND: 25. IQR 21-31; L-RPLND: 20, IQR 15-26; p: 0.001), hospital stay (L-RPLND: 3 days, IQR 3-4; O-RPLND: 6 days, IQR 5-8; p: .001) and grade \u22652 complications (L-RPLND 7%, O-RPLND 22%; p: 0.1) were the only significant differences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Primary RPLND is safe in stage II GCT, including seminoma, and may warrant a cure rate greater than 70%. When feasible, L-RPLND may be as effective as O-RPLND with better tolerability.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03008916221112697","type":"journal-article","created":{"date-parts":[[2022,8,2]],"date-time":"2022-08-02T00:46:29Z","timestamp":1659401189000},"page":"379-386","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Retroperitoneal lymph-node dissection (RPLND) as upfront management in stage II germ-cell tumours: Evaluation of safety and efficacy"],"prefix":"10.1177","volume":"109","author":[{"given":"Nicola","family":"Nicolai","sequence":"first","affiliation":[{"name":"Testis Surgery Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy"},{"name":"Urology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5945-3248","authenticated-orcid":false,"given":"Sebastiano","family":"Nazzani","sequence":"additional","affiliation":[{"name":"Urology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Tesone","sequence":"additional","affiliation":[{"name":"Urology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto","family":"Macchi","sequence":"additional","affiliation":[{"name":"Urology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luigi","family":"Piva","sequence":"additional","affiliation":[{"name":"Urology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Salvioni","sequence":"additional","affiliation":[{"name":"Urology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia","family":"Stagni","sequence":"additional","affiliation":[{"name":"Urology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tullio","family":"Torelli","sequence":"additional","affiliation":[{"name":"Urology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edoardo","family":"Agostini","sequence":"additional","affiliation":[{"name":"Urology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Celso","sequence":"additional","affiliation":[{"name":"Urology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrizia","family":"Giannatempo","sequence":"additional","affiliation":[{"name":"Medical Oncology Dept, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2498-402X","authenticated-orcid":false,"given":"Giuseppe","family":"Procopio","sequence":"additional","affiliation":[{"name":"Medical Oncology Dept, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7135-4506","authenticated-orcid":false,"given":"Barbara","family":"Avuzzi","sequence":"additional","affiliation":[{"name":"Radiation Oncology Dept, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rodolfo","family":"Lanocita","sequence":"additional","affiliation":[{"name":"Radiology Department, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Cattaneo","sequence":"additional","affiliation":[{"name":"Pathology Department, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mario","family":"Catanzaro","sequence":"additional","affiliation":[{"name":"Urology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6552-2895","authenticated-orcid":false,"given":"Davide","family":"Biasoni","sequence":"additional","affiliation":[{"name":"Urology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,8,1]]},"reference":[{"key":"bibr1-03008916221112697","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2013.50.3409"},{"key":"bibr2-03008916221112697","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2011.05.055"},{"key":"bibr3-03008916221112697","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2015.07.044"},{"key":"bibr4-03008916221112697","unstructured":"NCCN Clinical Practice Guideline in Oncology. 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