title: Primary chemotherapy after orchidectomy for stage I and II nonseminoma.
abstract: The effectiveness of combination chemotherapy in advanced germ cell cancer has led to re-evaluation of treatment approaches in early disease. For patients with stage I nonseminoma it became possible to contemplate an observation policy, relying on chemotherapy to rescue those who relapsed. Subsequently it has been shown that two cycels of adjuvant chemotherapy can prevent relapse in those at high risk. For patients with stage II nonseminoma, a policy of primary chemotherapy postorchidectomy leads to high cure rates, with avoidance of retroperitoneal lymph node dissection, and only a minority of patients requiring lymphadenectomy. The excellent prognosis of these patients increases the importance of minimising risks of any long-term treatment toxicity.
authors.affiliation: Academic Department of Radiotherapy and Oncology, The Royal Marsden NHS Trust and the Institute of Cancer Research, Sutton, Surrey, United Kingdom.
authors.forename: A
authors.initials: A
authors.lastname: Horwich
authors.forename: M H
authors.initials: MH
authors.lastname: Cullen
authors.forename: S P
authors.initials: SP
authors.lastname: Stenning
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D018237:Germinoma / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D009367:Neoplasm Staging; D009919:Orchiectomy; D011379:Prognosis; D013736:Testicular Neoplasms / Q000473:pathology / Q000628:therapy*