比较单纯原发性腹膜后淋巴结清扫术 (pRPLND) 与 pRPLND  辅助化疗 (AC) 在病理 II 期 (PSII) 非精原性生殖细胞肿瘤 (NSGCT) 患者中的结果和治疗负担。玛格丽特公主癌症的回顾性回顾eTestes 癌症中心癌症数据库确定了 1995 年至 2020 年间 pRPLND 后患有 PSII NSGCT 的患者。主要结局是无复发生存期 (RFS)。次要结局包括疾病特异性生存率 (DSS)、复发治疗负担以及与复发相关的因素。该研究总共纳入了 109 名 PSII 患者。有 96 名患者单独接受 pRPLND 治疗，13 名患者接受 pRPLND  AC 治疗。中位随访时间为 61 个月。仅 pRPLND 组的 5 年 RFS 为 72%，而 pRPLND  AC 组为 92%（风险比 [HR] 4.372，95% 置信区间 [CI] 0.59-32.36；P = 0.11）。在仅使用 pRPLND 的组中，5 年 RFS 因 pN 阶段而异（pN1 = 94% vs pN2/N3 = 67%，P = 0.03）。尽管仅 pRPLND 组的复发率较高，但 5 年时的 DSS 相似（仅 pRPLND 98% vs 100% pRPLND   AC，P = 0.48）。仅 pRPLND 组中只有 24 名 (25%) 患者需要任何后续化疗。尽管生存率相似，但仅 pRPLND 组的 RPLND 后累积治疗负担总体上低于 pRPLND AC 组（组中每位患者平均化疗周期为 1.23 比 2.46）。大多数 PSII NSGCT 患者接受 pRPLND 治疗单独使用不会复发或需要化疗。尽管给予 AC 时复发风险较低，但生存率没有差异，但化疗负担较高。对于大多数接受 pRPLND 治疗的 PSII NSGCT 患者来说，AC 可能构成过度治疗。© 2024 作者。 BJU International 约翰·威利 (John Wiley) 出版

To compare the outcomes and treatment burden of primary retroperitoneal lymph node dissection (pRPLND) alone versus pRPLND + adjuvant chemotherapy (AC) in patients with pathological stage II (PSII) non-seminomatous germ cell tumours (NSGCT).Retrospective review of the Princess Margaret Cancer Center eTestes cancer database identified patients with PSII NSGCT after pRPLND between 1995 and 2020. The primary outcome was relapse-free survival (RFS). Secondary outcomes included disease-specific survival (DSS), burden of relapse treatment, and factors associated with relapse.A total of 109 PSII patients were included in the study. There were 96 patients treated with pRPLND alone and 13 treated with pRPLND + AC. The median follow-up was 61 months. The 5-year RFS was 72% for the pRPLND-only group vs 92% for the pRPLND + AC group (hazard ratio [HR] 4.372, 95% confidence interval [CI] 0.59-32.36; P = 0.11). Within the pRPLND-only group the 5-year RFS differed by pN stage (pN1 = 94% vs pN2/N3 = 67%, P = 0.03). Despite a higher relapse rate within the pRPLND-only group, the DSS was similar at 5 years (98% pRPLND only vs 100% pRPLND + AC, P = 0.48). Only 24 (25%) of the patients in the pRPLND-only group required any subsequent chemotherapy. Despite achieving similar survival, the cumulative post-RPLND treatment burden was less for the pRPLND-only group than the pRPLND+AC group overall (average 1.23 vs 2.46 cycles of chemotherapy per patient in group).The majority of patients with PSII NSGCT treated with pRPLND alone do not experience a recurrence or require chemotherapy. Despite a lower relapse risk when AC is given, no difference in survival was seen but higher chemotherapy burden was entertained. AC may constitute overtreatment for most patients with PSII NSGCT treated with pRPLND.© 2024 The Author(s). BJU International published by John Wiley & Sons Ltd on behalf of BJU International.