Open AccessManagement options for stage 1 nonseminomatous germ cell tumors of the testis
Author(s) -
Stephen D.W. Beck
Publication year - 2010
Publication title -
indian journal of urology/indian journal of urology
Language(s) - English
Resource type - Journals
eISSN - 1998-3824
pISSN - 0970-1591
DOI - 10.4103/0970-1591.60455
Subject(s) - medicine , retroperitoneal lymph node dissection , stage (stratigraphy) , germ cell tumors , disease , lymphovascular invasion , oncology , chemotherapy , germ cell , lymph node , radiology , testicular cancer , cancer , metastasis , paleontology , biochemistry , chemistry , gene , biology
Management of clinical stage I non seminomatous germ cell tumor includes surveillance, primary chemotherapy and retroperitoneal lymph node dissection. Stratifying clinical stage I disease to high-and low-risk groups for harboring micrometastic retroperitoneal disease (pathologic stage B) is based on pathologic characteristics of the primary tumor. The presence of embryonal dominant histology and lymphovascular invasion (high-risk group) predicts for a 50% incidence of retroperitoneal disease. Low-risk group, the absence of either factor, predicts a 20% chance of retroperitoneal disease. Irrespective of risk classification, all treatment modalities have equal survival rates of 99% to 100%, and differ only in their unique short and long-term modalities. The mode of treatment in clinical stage I disease should remain patient driven and is guided by the perceived morbidities of each therapy.