Computerized Tomography and Lymphangiography in Staging Testis Tumors

Abstract

The usefulness of computerized tomography, lymphangiography and tumor markers was examined in 20 consecutive patients with pathologic stage I or II nonseminomatous testicular tumors. Computerized tomography had a false negative rate of 40%, a false positive rate of 50% and an overall accuracy of 69%. Lymphangiography had a false negative rate of 42%, a false positive rate of 0 and an overall accuracy of 69%. The combination of computerized tomography and lymphangiography did not significantly improve the diagnostic accuracy of either technique alone. Because tumor markers usually were elevated in the presence of bulky metastatic disease that was detected easily by computerized tomography or lymphangiography, they did not add measurably to the sensitivity of computerized tomography or lymphangiography in the diagnosis of retroperitoneal lymph node metastases. Consequently, retroperitoneal lymphadenectomy remains the only reliable means for accurate staging of patients with nonseminomatous testicular tumors.