Retroperitoneal lymphadenectomy in clinical stage I nonseminomatous germinal testis cancer.

Thirty-six consecutive patients underwent retroperitoneal lymphadenectomy for clinical stage I nonseminomatous germinal testis cancer from January 1980 to August 1981. Retroperitoneal lymphnode metastases were pathologically documented in 8 cases (22.2%). No patient received adjuvant therapy following surgery. The disease relapsed in 4 patients (11.1%) always in the lung, from 5 to 7 months after lymphadenectomy. The pulmonary disease was minimal in 3 cases and bulky (1 lung nodule greater than 2 cm) in 1 patient. All the relapsed patients entered continuous complete remission with cisplatin, vinblastine and bleomycin (plus surgery in one case). All the 36 patients in this series are alive and disease-free after a follow-up period of 40-60 months from lymphadenectomy. Antegrade ejaculation was lost by 10 out of 13 cases who had undergone the bilateral lymphadenectomy (77%) and by 2 of the 21 adult patients who had had the unilateral dissection (9.5%). Unilateral retroperitoneal lymphadenectomy is recommended in patients with negative intra-operative findings who undergo surgery for clinical stage I nonseminomatous testis cancer.