Propensity-matched Analysis of Open Versus Robotic Primary Retroperitoneal Lymph Node Dissection for Clinical Stage II Testicular Cancer

The use of robotic approach to retroperitoneal lymph node dissection (RPLND) is increasing, but no comparative study addressing oncologic or perioperative outcomes has been reported. This study is the first to compare open and robotic RPLND using propensity score matching, allowing it to approximate results that might be observed in a randomized trial. We observed similar relapse risk, node yield, lower blood loss, and complication rate, and a marked improvement in the length of stay with the robotic approach. Primary robotic RPLND should be incorporated into guidelines provided that it is carried out by surgeons with high-volume experience in RPLND and testis cancer management.