Recurrences in surgical stage I nonseminomatous germ cell tumors of the testis.

A retrospective analysis of patients with surgical stage I nonseminomatous germ cell tumors of the testis was done in an attempt to define the pathogenesis of treatment failure. Of 138 patients 126 (91 per cent) remain free of disease, with a median followup of 5 or more years, and 12 (9 per cent) suffered relapse an average of 9 months after orchiectomy and retroperitoneal lymph node dissection. The majority of recurrences were in the lungs. Of 12 patients who had recurrence 6 were salvaged and are alive without evidence of disease 3 or more years after the second complete remission. A history of scrotal surgery or scrotal violation, the extent of the primary tumor and the presence of sarcomatous elements in the primary were not statistically significant risk factors in this study. A higher recurrence rate with embryonal carcinoma than with teratocarcinoma was not statistically significant.