Surgical treatment of clinical stage I nonseminomatous germ gell tumors of the testis.

The rationale for further treatment after orchiectomy and the logical basis of the principle therapeutic alternatives in the management of clinical state I nonseminomatous germ cell tumors of the testis have been reviewed. Retroperitoneal lymph node dissection provides the epitome of staging accuracy and a high degree of therapeutic effectiveness in clinical stage I nonseminomatous germ cell tumors of the testis and is associated with minimal early and late morbidity and a low mortality. However, all methods of further active therapy after radical orchiectomy are under legitimate scrutiny in view of the burden of unnecessary therapy, the accuracy of clinical staging, the ability to recognize failures early, and the high probability of successful treatment of such failures.