Is There Still a Role for Post-Chemotherapy Retroperitoneal Lymph Node Dissection for Nonseminomatous Germ Cell Tumors?
The use of chemotherapy for patients with metastatic testicular tumors has substantially changed treatment outcomes for these patients and enabled cure for almost all patients with disseminated disease. The role of adjuvant regional surgery for patients with disseminated nonseminomatous germ cell tumors who achieve serologic complete response and minimal/no radiologic residual is unclear. Active surveillance of such patients represents a reasonable alternative and may spare them unnecessary major surgery if remission is sustained. In the February 1 issue of the Journal of Clinical Oncology, Christian Kollmannsberger and colleagues reported results from a population-based study evaluating outcomes in 276 patients with disseminated germ cell tumors who received cisplatin-based combination chemotherapy. Patients achieving a complete remission (CR) or a tumor marker-negative partial remission (PR) with residual tumor <1 cm were managed with surveillance if permitted by institutional policy
