High-risk clinical stage I NSGCT: the case for RPLND

World J Urol. 2009 Aug;27(4):449-53. doi: 10.1007/s00345-009-0425-x. Epub 2009 Jun 2.

Abstract

Introduction: High-risk clinical stage I NSGCT patients are at significant risk of harbouring occult metastatic disease. In these patients, treatment options consist of retroperitoneal lymph node dissection (RPLND) or two cycles of primary BEP chemotherapy. Both these options provide a nearly 100% cure rate.

Materials and methods: We review the rationale for both treatments.

Conclusions: Advantages of RPLND include high cure rate with single modality therapy eliminating the need for chemotherapy with its attendant long-term toxicities in the majority of patients.

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Bleomycin / administration & dosage
  • Cisplatin / administration & dosage
  • Combined Modality Therapy
  • Etoposide / administration & dosage
  • Humans
  • Lymph Node Excision / methods*
  • Male
  • Neoplasm Metastasis / prevention & control
  • Neoplasm Staging
  • Neoplasms, Germ Cell and Embryonal / drug therapy
  • Neoplasms, Germ Cell and Embryonal / surgery*
  • Retroperitoneal Space
  • Risk Factors
  • Testicular Neoplasms / drug therapy
  • Testicular Neoplasms / surgery*

Substances

  • Bleomycin
  • Etoposide
  • Cisplatin

Supplementary concepts

  • BEP protocol