Trends of retroperitoneal lymphadenectomy use in patients with nonseminomatous germ cell tumor of the testis

A population-based study

Maxine Sun, Firas Abdollah, Lars Budaüs, Daniel Liberman, Zhe Tian, Monica Morgan, Rupinder Johal, Jan Schmitges, Shahrokh F. Shariat, Francesco Montorsi, Markus Greafen, Paul Perrotte, Pierre I. Karakiewicz

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background: Retroperitoneal lymphadenectomy (RPLND), chemotherapy, and active surveillance represent treatment options for patients with nonseminomatous germ-cell tumors of the testis (NSGCTT). Our objective was to assess the utilization rate of RPLND in patients with NSGCTT. Methods: Within the Surveillance, Epidemiology and End Results (SEER) cohort, 4,620 and 1,671 patients with stage I and II NSGCTT were diagnosed between the years 1988 and 2006. Univariable and multivariable logistic regression analyses were performed to test the predictors of RPLND use in respectively patients with stage I and II NSGCTT. Results: The rate of RPLND according to stage I and II was 27 and 58%, respectively. In patients with stage I disease, the rate of RPLND decreased from 39% in 1988-1995 to 18% in 2004-2006 (P < 0.001), and remained stable for stage II patients (62-56%, P = 0.2). Regional variability existed regarding the rate of RPLND use only in stage I (Utah: 51% vs. Louisiana: 16%). Multivariable analyses performed in stage I NSGCTT revealed that year of diagnosis, SEER registry, and age were significant predictors of RPLND use. However, none of these variables achieved statistical significance within stage II NSGCTT patients. Conclusions: In patients with stage I NSGCCT, the RPLND utilization rate decreased during the study span. This observation may be ascribed to wider use of surveillance or chemotherapy. No temporal difference was recorded in patients with stage II NSGCCT.

Original languageEnglish (US)
Pages (from-to)2997-3004
Number of pages8
JournalAnnals of Surgical Oncology
Volume18
Issue number10
DOIs
StatePublished - Jan 1 2011

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Lymph Node Excision
Testis
Population
Epidemiology
Nonseminomatous germ cell tumor
Drug Therapy
Registries
Logistic Models
Regression Analysis

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Trends of retroperitoneal lymphadenectomy use in patients with nonseminomatous germ cell tumor of the testis : A population-based study. / Sun, Maxine; Abdollah, Firas; Budaüs, Lars; Liberman, Daniel; Tian, Zhe; Morgan, Monica; Johal, Rupinder; Schmitges, Jan; Shariat, Shahrokh F.; Montorsi, Francesco; Greafen, Markus; Perrotte, Paul; Karakiewicz, Pierre I.

In: Annals of Surgical Oncology, Vol. 18, No. 10, 01.01.2011, p. 2997-3004.

Research output: Contribution to journalArticle

Sun, M, Abdollah, F, Budaüs, L, Liberman, D, Tian, Z, Morgan, M, Johal, R, Schmitges, J, Shariat, SF, Montorsi, F, Greafen, M, Perrotte, P & Karakiewicz, PI 2011, 'Trends of retroperitoneal lymphadenectomy use in patients with nonseminomatous germ cell tumor of the testis: A population-based study', Annals of Surgical Oncology, vol. 18, no. 10, pp. 2997-3004. https://doi.org/10.1245/s10434-011-1722-3
Sun, Maxine ; Abdollah, Firas ; Budaüs, Lars ; Liberman, Daniel ; Tian, Zhe ; Morgan, Monica ; Johal, Rupinder ; Schmitges, Jan ; Shariat, Shahrokh F. ; Montorsi, Francesco ; Greafen, Markus ; Perrotte, Paul ; Karakiewicz, Pierre I. / Trends of retroperitoneal lymphadenectomy use in patients with nonseminomatous germ cell tumor of the testis : A population-based study. In: Annals of Surgical Oncology. 2011 ; Vol. 18, No. 10. pp. 2997-3004.
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abstract = "Background: Retroperitoneal lymphadenectomy (RPLND), chemotherapy, and active surveillance represent treatment options for patients with nonseminomatous germ-cell tumors of the testis (NSGCTT). Our objective was to assess the utilization rate of RPLND in patients with NSGCTT. Methods: Within the Surveillance, Epidemiology and End Results (SEER) cohort, 4,620 and 1,671 patients with stage I and II NSGCTT were diagnosed between the years 1988 and 2006. Univariable and multivariable logistic regression analyses were performed to test the predictors of RPLND use in respectively patients with stage I and II NSGCTT. Results: The rate of RPLND according to stage I and II was 27 and 58{\%}, respectively. In patients with stage I disease, the rate of RPLND decreased from 39{\%} in 1988-1995 to 18{\%} in 2004-2006 (P < 0.001), and remained stable for stage II patients (62-56{\%}, P = 0.2). Regional variability existed regarding the rate of RPLND use only in stage I (Utah: 51{\%} vs. Louisiana: 16{\%}). Multivariable analyses performed in stage I NSGCTT revealed that year of diagnosis, SEER registry, and age were significant predictors of RPLND use. However, none of these variables achieved statistical significance within stage II NSGCTT patients. Conclusions: In patients with stage I NSGCCT, the RPLND utilization rate decreased during the study span. This observation may be ascribed to wider use of surveillance or chemotherapy. No temporal difference was recorded in patients with stage II NSGCCT.",
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T1 - Trends of retroperitoneal lymphadenectomy use in patients with nonseminomatous germ cell tumor of the testis

T2 - A population-based study

AU - Sun, Maxine

AU - Abdollah, Firas

AU - Budaüs, Lars

AU - Liberman, Daniel

AU - Tian, Zhe

AU - Morgan, Monica

AU - Johal, Rupinder

AU - Schmitges, Jan

AU - Shariat, Shahrokh F.

AU - Montorsi, Francesco

AU - Greafen, Markus

AU - Perrotte, Paul

AU - Karakiewicz, Pierre I.

PY - 2011/1/1

Y1 - 2011/1/1

N2 - Background: Retroperitoneal lymphadenectomy (RPLND), chemotherapy, and active surveillance represent treatment options for patients with nonseminomatous germ-cell tumors of the testis (NSGCTT). Our objective was to assess the utilization rate of RPLND in patients with NSGCTT. Methods: Within the Surveillance, Epidemiology and End Results (SEER) cohort, 4,620 and 1,671 patients with stage I and II NSGCTT were diagnosed between the years 1988 and 2006. Univariable and multivariable logistic regression analyses were performed to test the predictors of RPLND use in respectively patients with stage I and II NSGCTT. Results: The rate of RPLND according to stage I and II was 27 and 58%, respectively. In patients with stage I disease, the rate of RPLND decreased from 39% in 1988-1995 to 18% in 2004-2006 (P < 0.001), and remained stable for stage II patients (62-56%, P = 0.2). Regional variability existed regarding the rate of RPLND use only in stage I (Utah: 51% vs. Louisiana: 16%). Multivariable analyses performed in stage I NSGCTT revealed that year of diagnosis, SEER registry, and age were significant predictors of RPLND use. However, none of these variables achieved statistical significance within stage II NSGCTT patients. Conclusions: In patients with stage I NSGCCT, the RPLND utilization rate decreased during the study span. This observation may be ascribed to wider use of surveillance or chemotherapy. No temporal difference was recorded in patients with stage II NSGCCT.

AB - Background: Retroperitoneal lymphadenectomy (RPLND), chemotherapy, and active surveillance represent treatment options for patients with nonseminomatous germ-cell tumors of the testis (NSGCTT). Our objective was to assess the utilization rate of RPLND in patients with NSGCTT. Methods: Within the Surveillance, Epidemiology and End Results (SEER) cohort, 4,620 and 1,671 patients with stage I and II NSGCTT were diagnosed between the years 1988 and 2006. Univariable and multivariable logistic regression analyses were performed to test the predictors of RPLND use in respectively patients with stage I and II NSGCTT. Results: The rate of RPLND according to stage I and II was 27 and 58%, respectively. In patients with stage I disease, the rate of RPLND decreased from 39% in 1988-1995 to 18% in 2004-2006 (P < 0.001), and remained stable for stage II patients (62-56%, P = 0.2). Regional variability existed regarding the rate of RPLND use only in stage I (Utah: 51% vs. Louisiana: 16%). Multivariable analyses performed in stage I NSGCTT revealed that year of diagnosis, SEER registry, and age were significant predictors of RPLND use. However, none of these variables achieved statistical significance within stage II NSGCTT patients. Conclusions: In patients with stage I NSGCCT, the RPLND utilization rate decreased during the study span. This observation may be ascribed to wider use of surveillance or chemotherapy. No temporal difference was recorded in patients with stage II NSGCCT.

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JO - Annals of Surgical Oncology

JF - Annals of Surgical Oncology

SN - 1068-9265

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