Results of treatment of non-seminomatous tumours of the testis in pathological stage I

During the period 1963-1978, 61 patients with a stage I nonseminomatous germ cell tumour of the testis were treated by transabdominal bilateral retroperitoneal lymph-node dissection. Five patients developed lung metastasis in the course of the follow-up, two retroperitoneal node metastases, and one of these two developed lung metastases as well. The patients with lung metastases were treated by chemotherapy, sometimes combined with surgery. The three-year survival was 97%. The pre-operative staging procedure in stage I was highly unreliable. Of 72 patients in clinical stage I, 23 (32%) had intra-abdominal metastases. New developments in the staging and treatment of patients with a non-seminomatous germ cell tumour of the testis are discussed. Although the retroperitoneal lymph-node dissection is the most accurate staging method, it seems justifiable to be less aggressive in the staging and treatment of patients with a stage I non-seminomatous testicular tumour.