A Clinical Trial of Primary Retroperitoneal Lymph Node Dissection in Patients With Testicular Seminoma With Limited Retroperitoneal Metastases

Launched by WESTERN UNIVERSITY, CANADA · Apr 9, 2025

Keywords

ClinConnect Summary

This clinical trial is studying a surgical approach called retroperitoneal lymph node dissection (RPLND) for men with testicular seminoma, a type of testicular cancer. Specifically, it focuses on patients who have a limited spread of cancer to the lymph nodes in the abdomen, which are enlarged but still small (no more than 3 cm). While there are effective treatments like chemotherapy and radiation that can cure about 90% of these cases, some patients and doctors are concerned about the long-term side effects of those treatments. This trial aims to see if surgery can be a safer option for these patients.

To be eligible for the trial, participants must be adult men (over 18) who have been diagnosed with pure seminoma after surgery to remove a testicle. They should have either had a relapse of cancer after initial treatment or have been diagnosed with advanced cancer at the start. Additionally, their imaging tests must show no more than two enlarged lymph nodes, and certain blood tests must be normal. This trial is not yet recruiting participants, but it could offer a new treatment path for men facing this challenge.

Gender

MALE

Eligibility criteria

• Inclusion Criteria:
• • 1. Adult patients (\>18 years) with pure seminoma on radical orchiectomy specimen.
• • 2. Initial CS I presentation with subsequent retroperitoneal relapse on surveillance, or de novo CS II at presentation.
• • 3. Axial imaging of lymphadenopathy within 8 weeks of the date of RPLND
• • 1. No more than 2 enlarged retroperitoneal lymph nodes, each no more than 3cm in the primary landing zones.
• • 2. Suitable for proposed bilateral RPLND template
• • 4. Serum tumour markers (alpha-fetoprotein (AFP), human chorionic gonadotropin (HCG), and lactate dehydrogenase (LDH)) must all be within normal limits within 2 weeks of planned RPLND
• Exclusion Criteria:
• • 1. Any condition deemed by the treating surgeon to pose an unacceptable risk for retroperitoneal lymph node dissection
• • 2. Any non-seminoma component on the orchiectomy specimen.
• • 3. AFP \>20 at any time point, pre- or post-orchiectomy.