The evolving role for surgery in the management of nonseminomatous testicular carcinoma
Once the only therapy available for locoregional disease extension, the approriate role for surgical management by retroperitoneal lymphadenectomy (RPND) of nonseminomatous germ cell testicular cancer is now being redefined in an algorithm of management comprising several modalities. Nerve-sparing techniques for RPND have overcome a substantial hesitancy for its continued utilization. Its continued use in low stage disease provides both therapeutic and diagnostic benefit; its role in relation to surveillance protocols will be defined. For bulky disease, node dissection is best reserved after induction chemotherapy; the need for surgery after such chemotherapy will be reviewed. © 1990 Springer-Verlag.
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