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Node Removal Count Impacts Testicular Cancer Recurrence

Researchers find higher two-year relapse-free rate associated with more nodes removed

FRIDAY, June 11 (HealthDay News) -- The number of retroperitoneal lymph nodes removed and analyzed in post-chemotherapy retroperitoneal lymph node dissection (PC-RPLND) appears to be a significant predictor of testicular cancer recurrence, according to research published in the June issue of Urology.

Brett S. Carver, M.D., of the Memorial Sloan-Kettering Cancer Center in New York City, and colleagues evaluated data on 628 patients who underwent PC-RPLND, of whom 57 percent turned out to have fibrosis and 43 percent had teratoma, to see if there was an association between the number of lymph nodes dissected and disease recurrence.

The median number of lymph nodes removed was 25. The researchers found that both increased size of post-chemotherapy nodes and lower lymph node counts to be significant predictors of disease recurrence. The predicted two-year relapse-free probability rate was 97 percent in those who had 50 nodes removed, versus 90 percent in patients who had only 10 nodes removed.

"Our data suggest that the total number of lymph nodes removed and analyzed is an independent predictor of disease recurrence after PC-RPLND. This has implications both for the urologist to assure completeness of resection and for the pathologist to meticulously assess the pathologic specimens," the authors write.

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