Can retroperitoneal lymphadenectomy be omitted in some patients after chemotherapy?

The advances in the therapy of high-volume stage II and stage III testicular cancer have been largely due to the development and success of cisplatin-based chemotherapy. Though patients with low- to moderate-volume stage II disease historically were curable with radical retroperitoneal lymph node dissection, patients with higher volumes of metastatic disease were not curable with surgery alone. The advent of cisplatin-based chemotherapy in the 1970s has allowed many of these patients with higher-volume metastatic disease to be cured. Though chemotherapy clearly plays the major role in the therapy of these patients, surgery after chemotherapy has been complimentary in the overall chance for cure of these patients.