Abstract
Massive retroperitoneal tumors were resected successfully from 20 patients by the modified thoracoabdominal approach. Of these 20 patients, 19 had primary nonseminomatous testicular cancer and 1 had a primary leiomyosarcoma. Fourteen patients are currently free of tumor. Salient features of the successful management of these patients were the use of intensive chemotherapy before attempted surgical resection, aggressive surgical efforts that may necessitate major vascular resections and, in particular, use of the modified thoracoabdominal approach, which is described and illustrated in detail.