Germinal Malignancies of the Testis: Experience, Management and Prognosis

Abstract

A review of the experience with 134 patients with germinal cell testicular neoplasia indicates that definitively accurate staging of the malignancy at presentation is the single most important prognostic factor. Nearly 2/3 of the patients with all types of germinal malignancies survived or died of other causes, and the highest survival rates were seen among patients with earlier stages of seminoma. In recent years patients with all types of germinal malignancies of the testis were treated by radical retroperitoneal lymphadenectomy with enhancement of survivals. Patients with seminoma and nonseminomatous tumors exhibited increased survival rates with node dissection. In 66 lymphadenectomies the complication rate was less than 14%, with only 1 death related to the operation. Retroperitoneal lymphadenectomy not only affords therapeutic advantage but also provides an opportunity for accurate surgical staging of disease and allows for a rational decision relative to additional treatment, radiation therapy or chemotherapy.