Conservative management of the retroperitoneum for stages I and II nonseminomatous germ cell tumors

✍ Scribed by A. C. Eschenbach; M. E. Gleave; D. A. Swanson

• Publisher: Springer-Verlag
• Year: 1992
• Tongue: English
• Weight: 675 KB
• Volume: 10
• Category: Article
• ISSN: 0724-4983
• DOI: 10.1007/bf00186090

✦ Synopsis

Recent advances in the therapy of disseminated, nonseminomatous germ cell tumors of the testis have prompted the consideration of less aggressive management of those patients with locoregional disease. In order to avoid the morbidity of staging retroperitoneal lymph node dissection, protocols of surveillance alone following radical orchiectomy have demonstrated that approximately 70°7o of clinical stage I patients have a long-term cancer-free survival without further therapy. Recognition of risk factors for relapse has enabled a more selective and discriminating use of adjunctive therapy such as retroperitoneal node dissection. For patients who present with clinical evidence of metastasis in the retroperitoneum (stage II), primary chemotherapy is a suitable alternative to retroperitoneal node dissection in selected patients. The objective of modern integrated therapy is to ensure long-term cancer-free survival with minimal and the least morbid therapy.