[The role of salvage surgery following chemotherapy in advanced testicular cancer].

Twenty-seven patients with advanced testicular cancer underwent cisplatin-based combination chemotherapy and followed by salvage surgery. Complete necrosis and/or fibrosis (necrosis) was found in 12 (44%) operative specimens, mature teratoma in 5 (19%) and residual cancer in 10 (37%) patients. Ten of the 12 (83%) patients with necrosis and all 5 with mature teratoma were rendered disease-free (NED). Only 6 of the 10 (60%) patients with residual cancer were continuously NED. These findings suggest that if carcinoma is found in the resected specimen, further salvage chemotherapy is required. Salvage surgery should be avoided in patients with elevated serum tumor marker levels.