Modified RLND as a means to preserve ejaculation.

According to the results of this trial it is evident that radical RLND constitutes an overtreatment in NSGCTT pathological stage I. The modified RLND limiting the areas of dissection to recognized sentinel nodes combines accurate pathological staging with low morbidity and equal success in terms of postoperative relapse; it is superior to radical RLND in preserving ejaculatory ability. It will thus come to replace the radical approach and will compete favorably with expectant therapy for some time to come. Results of prospective and long-term investigations will help to define subsets of stage I patients for whom RLND may be unnecessary (DeWys et al. 1983; Oliver et al. 1984).