Orchiectomy alone in the treatment of clinical stage I nonseminomatous germ cell tumor of the testis.

Abstract

Patients (45) with clinical stage I nonseminomatous germ cell tumor of the testis (NSGCTT) were entered in a prospective clinical trial to receive no treatment other than orchiectomy until clinical evidence of relapse. Of this group, 36 patients (80%) were continuously free of disease for a median duration of 19.5 mo. after orchiectomy. Nine patients (20%) relapsed, 8 within 7 mo. of orchiectomy. Of 9 relapsing patients, 7 were rendered free of disease with chemotherapy and/or surgery for a median duration of 7 mo. (range, 1-33 mo.) after completion of treatment; the other 2 patients are presently under treatment although one has progressive disease. The relapse rate was higher in patients with embryonal carcinoma than in those with teratocarcinoma, 57% vs. 17%. These preliminary results imply that the omission of routine lymphadenectomy or lymph node irradiation in clinical stage I NSGCTT deserves further trial.