Evolution and controversies in the management of low-stage nonseminomatous germ-cell tumors of the testis.

Abstract:

:The results of changing treatment modalities in 690 consecutive patients with low stages nonseminomatous germ-cell tumors (NSGCT) of the testis were analyzed. Overall, 120 patients (17.4%) suffered relapses, and 25 (3.6%) died of cancer after a follow-up period ranging from 2 to 20 years. The indications for primary (nerve-sparing) retroperitoneal lymph-node dissection (RPLND) were gradually restricted from clinical stages I, IIA, and IIB to stages I and IIA with normal postorchiectomy markers only, but we recognize that the management of clinical stage I NSGCT of the testis remains controversial. All other patients may be treated with primary chemotherapy followed by nerve-sparing RPLND for any residual mass. Adjuvant chemotherapy is mandatory in pathological stage IIC disease, but this pathological category will disappear with adoption of the restrictions for primary nerve-sparing RPLND, and two courses of adjuvant chemotherapy are adequate treatment for patients with pathological stages IIA and IIB disease, who cannot be carefully followed.

journal_name

World J Urol

journal_title

World journal of urology

authors

Pizzocaro G,Nicolai N,Salvioni R

doi

10.1007/BF00192265

subject

Has Abstract

pub_date

1994-01-01 00:00:00

pages

113-9

issue

3

eissn

0724-4983

issn

1433-8726

journal_volume

12

pub_type

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