Retroperitoneal Lymph Node Dissection (RPLND) for Testicular Cancer | Uro-Oncology Center of University Hospital Cologne

Retroperitoneal lymph node dissection (RPLND) at the Uro-Oncology Center of University Hospital Cologne is performed as part of a dedicated testicular cancer program with extensive expertise in the surgical management of testicular germ cell tumors. The Cologne urology department identifies primary and post-chemotherapy retroperitoneal lymph node dissections as a major focus of its testicular cancer service and has reported performing more of these procedures than any other urological clinic in Europe. The procedure is particularly specialized at this center because the department treats complex residual tumors after chemotherapy as well as primary retroperitoneal disease. Surgical strategy can be adapted to the location and extent of residual disease, including nerve-sparing and modified-field approaches for selected patients and radical bilateral lymph node dissection for larger or more extensive residual tumors. The department has also developed and published criteria to guide the surgical management of post-chemotherapy residual tumors. Patients receive RPLND within University Hospital Cologne's certified Uro-Oncology Center and its dedicated Testicular Cancer Center. The testicular cancer center has been certified by the European Society of Urology and the European Board of Urology as a European Testicular Cancer Center, while the testicular cancer program is also integrated into the DKG-certified uro-oncology structure of the CIO Cologne. Another important advantage is the multidisciplinary treatment structure. Decisions for complex testicular cancer cases can be coordinated through an interdisciplinary tumor board, with access to urological surgery, systemic oncology, radiotherapy, and specialized diagnostics within the university hospital. The unit also operates as an accredited second-opinion center for testicular germ cell tumors, making the facility particularly relevant when the indication for RPLND needs careful assessment after imaging, tumor-marker evaluation, or previous chemotherapy. The program also combines high-volume clinical practice with active research in testicular cancer surgery. Its COTRIMS clinical study specifically investigates retroperitoneal lymphadenectomy for selected patients with metastatic seminoma, including progression-free survival, perioperative complications, quality of life, and postoperative retrograde ejaculation. This research environment supports an approach in which the extent and role of RPLND are considered according to the individual tumor situation rather than as a uniform surgical procedure.