Secondary surgery in advanced testicular germ-cell tumors.

Twenty-four patients with residual tumor after intensive chemotherapy for advanced testicular germ-cell tumors were subjected to secondary surgery. Twenty patients had complete resection with the following distribution of histological types: 4 embryonal carcinoma, 9 mature teratoma and 7 fibrous tissue. Eighteen of these patients remain free of disease. Four patients had incomplete resection. Two of these patients with embryonal carcinoma died later despite further treatment; 2 patients with teratoma remain free of disease. Secondary surgery is recommended in cases where residual tumor is found after intensive chemotherapy and where tumor markers are not elevated.