Evidence map›Paper›PMID 34599350›Full record

ArticleWorld journal of urology2022

A comparative study of peri-operative outcomes for 100 consecutive post-chemotherapy and primary robot-assisted and open retroperitoneal lymph node dissections.

Paul Lloyd, Anne Hong, Marc A Furrer, Elaine W Y Lee, Harveer S Dev, Maurice H Coret, James M Adshead, Peter Baldwin, Richard Knight, Jonathan Shamash and 9 more

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in World journal of urology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 4 syntheses or guidelines pooled it.

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  14. Treatment de-escalation for stage II seminoma.Nature reviews. Urology · 2023
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

19 authors.

Paul Lloyd *Department of Urology, Addenbrooke's Hospital, Cambridge University Hospitals, Cambridge, UK.
Anne Hong *Department of Urology, Royal Melbourne Hospital, Melbourne, Australia.
Marc A FurrerDepartment of Urology, Royal Melbourne Hospital, Melbourne, Australia.
Elaine W Y LeeDepartment of Urology, Addenbrooke's Hospital, Cambridge University Hospitals, Cambridge, UK.
Harveer S DevDepartment of Urology, Addenbrooke's Hospital, Cambridge University Hospitals, Cambridge, UK.
Maurice H CoretDepartment of Urology, Addenbrooke's Hospital, Cambridge University Hospitals, Cambridge, UK.
James M AdsheadDepartment of Urology, Lister Hospital, Stevenage, UK.
Peter BaldwinDepartment of Gynae-Oncology, Addenbrooke's Hospital, Cambridge, UK.
Richard KnightDepartment of Urology, Addenbrooke's Hospital, Cambridge University Hospitals, Cambridge, UK.
Jonathan ShamashDepartment of Oncology, St Bartholomew's Hospital, London, UK.
Constantine AlifrangisDepartment of Oncology, University College London Hospital, London, UK.
Sara StonehamDepartment of Oncology, University College London Hospital, London, UK.
Danish MazharDepartment of Oncology, Addenbrooke's Hospital, Cambridge University Hospitals, Cambridge, UK.
Han WongDepartment of Oncology, Addenbrooke's Hospital, Cambridge University Hospitals, Cambridge, UK.
Anne WarrenDepartment of Pathology, Addenbrooke's Hospital, Cambridge University Hospitals, Cambridge, UK.
Ben TranDepartment of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia.
Nathan LawrentschukDepartment of Urology, Royal Melbourne Hospital, Melbourne, Australia.
David E NealDepartment of Urology, Addenbrooke's Hospital, Cambridge University Hospitals, Cambridge, UK.
Benjamin C ThomasDepartment of Urology, Addenbrooke's Hospital, Cambridge University Hospitals, Cambridge, UK. benjamin.thomas@mh.org.au.ORCID http://orcid.org/0000-0002-1330-122X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo describe and compare differences in peri-operative outcomes of robot-assisted (RA-RPLND) and open (O-RPLND) retroperitoneal lymph node dissection performed by a single surgeon where chemotherapy is the standard initial treatment for Stage 2 or greater non-seminomatous germ cell tumour.

methodsReview of a prospective database of all RA-RPLNDs (28 patients) and O-RPLNDs (72 patients) performed by a single surgeon from 2014 to 2020. Peri-operative outcomes were compared for patients having RA-RPLND to all O-RPLNDs and a matched cohort of patients having O-RPLND (20 patients). Further comparison was performed between all patients in the RA-RPLND group (21 patients) and matched O-RPLND group (18 patients) who had previous chemotherapy. RA-RPLND was performed for patients suitable for a unilateral template dissection. O-RPLND was performed prior to the introduction of RA-RPLND and for patients not suitable for RA-RPLND after its introduction.

resultsRA-RPLND showed improved peri-operative outcomes compared to the matched cohort of O-RPLND-median blood loss (50 versus 400 ml, p < 0.00001), operative duration (150 versus 195 min, p = 0.023) length-of-stay (1 versus 5 days, p < 0.00001) and anejaculation (0 versus 4, p = 0.0249). There was no statistical difference in complication rates. RA-RPLND had lower median lymph node yields although not significant (9 versus 13, p = 0.070). These improved peri-operative outcomes were also seen in the post-chemotherapy RA-RPLND versus O-RPLND analysis. There were no tumour recurrences seen in either group with median follow-up of 36 months and 60 months, respectively.

conclusionsPost-chemotherapy RA-RPLND may have decreased blood loss, operative duration, hospital length-of-stay and anejaculation rates in selected cases and should, therefore, be considered in selected patients. Differences in oncological outcomes require longer term follow-up.

Indexed as

Robotic Surgical ProceduresCombined Modality TherapyHumansLymphatic MetastasisLymph Node ExcisionMaleNeoplasms, Germ Cell and EmbryonalRetroperitoneal SpaceTesticular NeoplasmsTreatment OutcomeRetroperitoneal lymph node dissectionRobotic surgeryTesticular cancer

Identifiers

PMID34599350

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.