Alternative to retroperitoneal lymphadenectomy with preservation of ejaculation and fertility in stage I nonseminomatous testicular cancer. A prospective study

Abstract

Twenty patients with clinical Stage I nonseminomatous testicular cancer have been staged by retroperitoneal exploration and removal of landing zone lymphatics. Only two patients had microscopic metastases to these landing zone lymphatics and underwent retroperitoneal lymph node dissection. Two patients developed chest metastases in 2 to 5-year follow-up. All patients had preservation of ejaculation and their fertility status. This relatively brief surgical staging avoids the complications of a formal lymphadenectomy with 100% survival, and cost-effectiveness with excellent quality of life due to minimal complications.