Please use this identifier to cite or link to this item: doi:10.22028/D291-37692
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Title: Preoperative clinical and radiographic predictors of major vascular surgery in patients with testicular cancer undergoing post-chemotherapy residual tumor resection (PC-RPLND)
Author(s): Nini, Alessandro
Boschheidgen, Matthias
Hiester, Andreas
Winter, Christian
Antoch, Gerald
Schimmöller, Lars
Albers, Peter
Language: English
Title: World Journal of Urology
Volume: 40 (2022)
Issue: 2
Pages: 349-354
Publisher/Platform: Springer Nature
Year of Publication: 2021
Free key words: Testicular cancer
PC-RPLND
Radiology
Vascular surgery
DDC notations: 610 Medicine and health
Publikation type: Journal Article
Abstract: Purpose To evaluate the probability to correctly predict major vascular surgery (MVS) in patients undergoing postchemotherapy retroperitoneal lymph node dissection (PC-RPLND) for testicular cancer. Methods From a database of 504 RPLNDs performed in 434 patients (2008–2018), 78 patients submitted to PC-RPLND for non-seminoma germ-cell cancer after cisplatin-based chemotherapy with available preoperative CT scans were identifed. Second PC-PLNDs (Re-Dos), salvage RPLNDs, or RPLNDs for late-relapse were excluded as well as thoraco-abdominal approaches. Preoperative imaging was reviewed by a urologist and a radiologist blinded to operative details. Results Of 78 patients, 16 (20.5%) underwent MVS (caval and/or aortic replacement or reconstruction). On univariable analyses, transversal diameter, sagittal diameter, tumor volume, aorta- and cava-tumor contact angle, poor IGCCCG score, clinical stage III and preoperative positive markers were predictors of MVS (all p values≤0.01). At multivariable analyses aorta- (cut-of 64°) and cava-tumor contact angle (cut-of 98°) and poor IGCCCG score represented the three most important predictors of MVS (all p values≤0.05). The model constructed has a PPV 100%, NPV 87% and an accuracy of 88%. Conclusions Presence of aorta-tumor contact angle≥64°, cava-tumor contact angle≥98° and poor IGCCCG score identify correctly 9 out of 10 patients requiring MVS at the time of frst PC-RPLND.
DOI of the first publication: 10.1007/s00345-021-03870-8
URL of the first publication: https://link.springer.com/article/10.1007/s00345-021-03870-8
Link to this record: urn:nbn:de:bsz:291--ds-376928
hdl:20.500.11880/34097
http://dx.doi.org/10.22028/D291-37692
ISSN: 1433-8726
0724-4983
Date of registration: 25-Oct-2022
Faculty: M - Medizinische Fakultät
Department: M - Urologie und Kinderurologie
Professorship: M - Prof. Dr. Michael Stöckle
Collections:SciDok - Der Wissenschaftsserver der Universität des Saarlandes

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