Testicular germ cell tumors (GCTs) are aggressive but highly curable tumors. To avoid over/undertreatment, reliable clinical staging of retroperitoneal lymph-node metastasis is necessary. Current clinical guidelines, in their different versions, lack specific recommendations on how to measure lymph-node metastasis.
We aimed to assess the practice patterns of German institutions frequently treating testicular cancer for measuring retroperitoneal lymph-node size.
An 8-item survey was distributed among German university hospitals and members of the German Testicular Cancer Study Group.
In the group of urologists, 54.7% assessed retroperitoneal lymph nodes depending on their short-axis diameter (SAD) (33.3% in any plane, 21.4% in the axial plane), while 45.3% used long-axis diameter (LAD) for the assessment (42.9% in any plane, 2.4% in the axial plane). Moreover, the oncologists mainly assessed lymph-node size based on the SAD (71.4%). Specifically, 42.9% of oncologists assessed the SAD in any plane, while 28.5% measured this dimension in the axial plane. Only 28.6% of oncologists considered the LAD (14.3% in any plane, 14.3% in the axial plane). None of the oncologists and 11.9% of the urologists (n = 5) always performed an MRI for the initial assessment, while for follow-up imaging, the use increased to 36.5% of oncologists and 31% of urologists. Furthermore, only 17% of the urologists, and no oncologists, calculated lymph-node volume in their assessment (p = 0.224).
Clear and consistent measurement instructions are urgently needed to be present in all guidelines across different specialistic fields involved in testicular cancer management.
World journal of urology. 2023 Apr 04 [Epub ahead of print]
Justine Schoch, Kathrin Haunschild, Angelina Strauch, Kai Nestler, Hans Schmelz, Pia Paffenholz, David Pfister, Thorsten Persigehl, Axel Heidenreich, Tim Nestler
Department of Urology, Federal Armed Forces Hospital Koblenz, Ruebenacherstrasse 170, 56072, Koblenz, Germany., Department of Urology, Faculty of Medicine, University Hospital Cologne, University Cologne, Cologne, Germany., Institute of Diagnostic and Interventional Radiology, Federal Armed Forces Hospital Koblenz, Koblenz, Germany., Institute for Diagnostic and Interventional Radiology, Faculty of Medicine, University Hospital Cologne, University Cologne, Cologne, Germany., Department of Urology, Federal Armed Forces Hospital Koblenz, Ruebenacherstrasse 170, 56072, Koblenz, Germany. .
PubMed http://www.ncbi.nlm.nih.gov/pubmed/37014392