Login to Access Video or Poster Abstract: MP25-06
Sources of Funding: none

Introduction

Preservation of periaortic nerve plexus during retroperitoneal dissection (RPLND) is considered a key to maintaining ejaculation function in patients with testicular cancer. Nerve-sparing techniques are often employed during primary RPLND. However, in patients undergoing RPLND after chemotherapy the rates of nerve sparing and its impact is not very clear. We sought to evaluate our experience with nerve sparing in patients undergoing RPLND for testicular cancer._x000D_

Methods

On retrospective review of our database (2006-2015), 73 patients were included in the study. Patient demographics, clinical, pathological, and patient reported ejaculation function information was obtained. Non-parametric tests were used for analysis.

Results

Median age of the cohort was 29 years (IQR 23-66). Non-seminoma histology was noted in 65% patients with 43% patients noted to have lympho-vascular invasion. A total of 51% patients had post-orchiectomy elevated tumor markers and 59% underwent chemotherapy. Post-chemotherapy elevated tumor markers were noted in 11% patients and 27% patients had residual mass. On RPLND, 23% patients noted to have germ cell tumor and 14% noted to have teratoma in the excised nodes/mass. Bilateral template RPLND was performed in 74% of the patients. In patients with primary RPLND, nerve sparing was performed in 83% of the patients and in patient with post-chemo RPLND; nerve sparing was performed in 54% of the patients. In patients with primary RPLND with nerve sparing 82% (CI 57-94) had ejaculation function and in patients with post chemo RPLND 76% (CI 51-90) patients had ejaculation function (p=0.67)

Conclusions

Preservation of periaortic nerves is feasible both in patients undergoing primary as well as post-chemotherapy RPLND with maintenance of high rate of ejaculation function. There is no significant difference in preservation of ejaculation function between primary and post chemotherapy RPLND groups when optimal surgical technique is used to preserve the periaortic nerves. _x000D_

Funding

none