Carcinoma of the testis.

Patients with Stage I or II malignant testis germ cell tumors underwent a randomized prospective study at Walter Reed Hospital, Washington, D.C., from 1968 to 1973. Pure cell lines of seminoma or choriocarcinoma were excluded. Forty patients had inguinal orchiectomy followed by irradiation to the inguinal, iliac, lumbar para-aortic, mediastinal and supraclavicular lymph nodes. Thirty-four patients (85%) in this group are alive and free of tumor a minimum of 3 years. Fifty-one patients received pre- and postoperative irradiation to primary lymphatic pathways in association with bilateral retroperitoneal lymphadenectomy as well as elective irradiation to the mediastinum and supraclavicular regions. Forty-six patients (90%) in this second group are alive and free of tumor a minimum of three years. Both treatment methods represent marked improvement in cure rates compared to lymphadenectomy and postoperative irradiation utilized prior to 1968, but no statistically significant difference from each other.