Surveillance versus nerve-sparing retroperitoneal lymphadenectomy in stage I nonseminomatous germ-cell tumors.
As in any health care situation, treatment for stage I nonseminomatous germ-cell tumor of the testis must be adapted to the needs of the individual patient, and a surveillance protocol may not always provide optimal care. Of concern is the relative paucity of information about relapse rates beyond 4 years, the long-term effects of salvage chemotherapy, and the potential of subclinical disease to become manifest many years after diagnosis. However, for the reliable patient with a stage I tumor demonstrating no histopathologic features indicative of a high risk of relapse, close surveillance may offer the advantages of a high likelihood of survival with less intervention and lower morbidity.
Division of Urology, Oregon Health Sciences University, Portland.
B A
BA
Lowe
D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D009364:Neoplasm Recurrence, Local; D009373:Neoplasms, Germ Cell and Embryonal / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D012187:Retroperitoneal Space; D013736:Testicular Neoplasms / Q000473:pathology / Q000601:surgery / Q000628:therapy*