title: Delayed orchiectomy after chemotherapy for metastatic nonseminomatous germ cell tumors.
abstract: OBJECTIVE
  We reviewed current experience at our university with delayed orchiectomy after chemotherapy in patients with metastatic nonseminomatous germ cell tumors.
  
  
  METHODS
  We retrospectively analyzed the records of 160 patients with metastatic germ cell cancer who were given systemic chemotherapy, and subsequently underwent orchiectomy and retroperitoneal lymph node dissection.
  
  
  RESULTS
  Analysis of 160 testicular specimens revealed necrosis or scar in 70 (43.7%), pure teratoma in 50 (31.2%) and persistent germ cell cancer in 40 (25%). Corresponding incidences of histopathological findings in the post-chemotherapy retroperitoneal lymph node dissection specimens were significantly different, correlating with less than half of the cases (chi-square, p = 0.002).
  
  
  CONCLUSIONS
  Our study confirms the need for delayed orchiectomy after systemic chemotherapy even when there seems to be a partial or complete clinical response at other sites.
authors.affiliation: Department of Urology, Indiana University Medical Center, Indianapolis, USA.
authors.forename: I
authors.initials: I
authors.lastname: Leibovitch
authors.forename: J S
authors.initials: JS
authors.lastname: Little
authors.forename: R S
authors.initials: RS
authors.lastname: Foster
authors.forename: R G
authors.initials: RG
authors.lastname: Rowland
authors.forename: R
authors.initials: R
authors.lastname: Bihrle
authors.forename: J P
authors.initials: JP
authors.lastname: Donohue
mesh_terms: D000293:Adolescent; D000328:Adult; D003131:Combined Modality Therapy; D018237:Germinoma / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009919:Orchiectomy; D012189:Retrospective Studies; D013736:Testicular Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D013997:Time Factors