Radiology, Vol 139, 181-188, Copyright © 1981 by Radiological Society of North America
A comparison of treatment methods for germinal cell tumors of the testis other than pure seminoma
DH Hussey
The results of three 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, however, 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.
