A comparison of treatment methods for germinal cell tumors of the testis other than pure seminoma.

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Abstract
The results of 3 approaches to management of the regional lymphatics for Stage I and Stage II nonseminomatous testicular tumors were reviewed. For clinical Stage I disease, the results achieved with orchiectomy and radiation therapy alone are equal to those achieved with orchiectomy and lymphadenectomy. Although the results with preoperative radiotherapy and lymphadenectomy are slightly better, the lymphadenectomy almost always results in aspermia and infertility. The effectiveness of radiotherapy alone is determined by the volume of cancer. Local tumor control with irradiation is good if the tumor burden is relatively small. The local control rates are diminished if the metastases are greater than 2 cm in diameter. The results with preoperative radiotherapy and lymphadenectomy for patients with clinical Stage II disease are superior to those achieved with either primary lymphadenectomy or radiotherapy alone.