The following is a summary of “A systematic review of pN0 testicular seminoma: a new clinical entity and future directions,” published in the December 2023 issue of Urology by Farkouh, et al.
More research was being done on retroperitoneal lymph node dissection (RPLND) for testicular seminoma with swollen retroperitoneal lymph nodes. This has led to the discovery of a new disease called pN0 disease. Larger, nonmetastatic lymph nodes in the retroperitoneum give information about how seminoma usually behaves and can be used to make staging more accurate.
For a systematic review, researchers sought to report the rates of pN0, discuss the risk factors linked to it, and look at new research that may help lower its incidence. They looked at everything that was written about lymph nodes in people with testicular seminoma who were mostly treated with retroperitoneal lymph node removal. This included published papers in PubMed, Embase, Web of Science, and cancer meetings. Studies were not included if they did not report histology. There were 15 papers and summaries in all. There was a small chance of bias, even though the study methods differed. The stated pN0 rates generally ranged from 0% to 22%.
In planned clinical studies, it ranged from 9% to 16%. If there was a pN0, lymph nodes were smaller before surgery, had one swollen lymph node, or blood miRNA-371 level was negative. The high rate of pN0 seminoma was worrying because it suggested that patients may have been overtreated in the past. On the other hand, it marks a turning point in the study of testicular cancer, as better clinical staging will lead to clear patient benefits.
Source: sciencedirect.com/science/article/abs/pii/S1078143923003435
