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Retroperitoneal node dissection for metastasizing testicular cancer

General

Testicular cancer metastasizes lymphatically. Metastases are localized in the drainage area from the inner inguinal opening along the common iliac vein to lateral to the caval vein for right-sided cancer and along the aorta for left-sided cancer. Spreading stays for a long time distally to the renal vein on both sides before it metastasizes further up under the diaphragmatic curae and further to the mediastinum. The metastasis area on the right side extends along and around the caval vein and aorto-cavale area and can "jump" over to the left side in the area distal to the renal vein. On the left side, the metastasis area is located along and around the aorta and can "jump" over to the right side, also msot often distal to the renal vein.

Indication

  • Testicular cancer with spreading to the retroperitoneal space

Goal

  • The main goal is to cure the disease. However, the surgery is also of diagnostic importance for identifying tumors in the lymph nodes and deciding whether this is benign or malignant. This will be of importance for possible supplementary treatment and also for the follow-up procedure.  

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