1994
DOI: 10.1007/bf00192265
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Evolution and controversies in the management of low-stage nonseminomatous germ-cell tumors of the testis

Abstract: The results of changing treatment modalities in 690 consecutive patients with low stages nonseminomatous germ-cell tumors (NSGCT) of the testis were analyzed. Overall, 120 patients (17.4%) suffered relapses, and 25 (3.6%) died of cancer after a follow-up period ranging from 2 to 20 years. The indications for primary (nerve-sparing) retroperitoneal lymph-node dissection (RPLND) were gradually restricted from clinical stages I, IIA, and IIB to stages I and IIA with normal postorchiectomy markers only, but we rec… Show more

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Cited by 15 publications
(6 citation statements)
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“…After orchiectomy, surveillance alone, RPLND, or a short course of adjuvant chemotherapy in histologically high-risk patients represent the current options for managing stage I adult NSGCTT (7,8,(10)(11)(12)(13)(14). The choice between the three modalities is usually based on known risk factors, local practice, the availability of resources, and the patient's preference.…”
Section: Discussionmentioning
confidence: 99%
“…After orchiectomy, surveillance alone, RPLND, or a short course of adjuvant chemotherapy in histologically high-risk patients represent the current options for managing stage I adult NSGCTT (7,8,(10)(11)(12)(13)(14). The choice between the three modalities is usually based on known risk factors, local practice, the availability of resources, and the patient's preference.…”
Section: Discussionmentioning
confidence: 99%
“…All select patients did not receive any adjuvant treatment following surgery. 2 Personnel at the pathology unit at our institution were requested to review all specimens coming from other hospitals to reassess histopathological features. Vascular invasion (VI) was considered present if tumor cells adhering to endothelial cells forming a vascular lumen were identified.…”
Section: Methodsmentioning
confidence: 99%
“…The proper interpretation of computerized tomography (CT) of the retroperitoneum and of the serum tumor markers ␣-fetoprotein (AFP) and ␤-human chorionic gonadotropin (␤-HCG) half-life decay following orchiectomy permitted the modern definition of clinical stage I (CSI) disease as a condition of no clinical, radiological or biochemical evidence of disease beyond the testis. 1, 2 Traditional management of this stage of disease is represented by retroperitoneal lymphadenectomy (RPLND) [2][3][4] or surveillance following orchiectomy alone. [5][6][7] Evolving techniques such as nerve sparing 4 and maybe laparoscopy in the near future 8 render RPLND less morbid for these patients.…”
mentioning
confidence: 99%
“…Regarding left-sided tumors, the first nodal stations include the pre-aortic and para-aortic lymph nodes, left renal hilar nodes followed by the inter-aortocaval nodes [6]. Contralateral spread is common with right-sided tumors but is rarely seen with left-sided tumors and is usually associated with bulky disease [9]. More caudal deposits of metastatic disease usually reflect retrograde spread to distal iliac and inguinal lymph nodes secondary to a large volume of disease and, more rarely, aberrant testicular lymphatic drainage.…”
Section: Diagnosis and Surgical Managementmentioning
confidence: 99%