The role of retroperitoneal surgery in testis cancer.
Testis cancer is today a curable malignancy. But controversy remains about the appropriate management of patients presenting different stages. There is an increasing interest in surveillance rather than in primary retroperitoneal lymph node dissection (RPLND) for stage I non-seminomatous germ cell tumors (NSGCT). Adjuvant chemotherapy has become an efficient treatment option for high risk non-seminomatous germ cell testis cancer, however, biological and histologic risk factors of the primary tumor are not yet precisely defined. To determine the appropriate management of patients with testicular cancer, postoperative morbidity after RPLND and risk of chemotherapy-induced morbidity must be balanced. Whoever reviews the literature must take into consideration that the excellent postoperative results after RPLND depend on high volume and large experience with testis cancer. As treatment morbidity and its intensity have a major impact on testis cancer patient quality of life, the choice of management must be based on the patient's social situation, his personal needs, and the doctor's experience and resources.
Leisinger
Hans-Jürg
HJ
Department of Urology, University Hospital, CH-1011 Lausanne, Switzerland. hans-jurg.leisinger@chuv.hospvd.ch
Donohue
John P
JP
D000970:Antineoplastic Agents / Q000627:therapeutic use / Q000633:toxicity; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000628:therapy; D012187:Retroperitoneal Space / Q000601:surgery; D018239:Seminoma / Q000473:pathology / Q000601:surgery / Q000628:therapy; D013736:Testicular Neoplasms / Q000473:pathology / Q000601:surgery* / Q000628:therapy
D000970:Antineoplastic Agents