Significance of supraclavicular lymph node biopsy for staging, therapy and prognosis of testicular tumors.

Supraclavicular lymph node biopsies were performed in 40 patients with germinal testicular tumors. The radiologic visualization of both the thoracic ducts and the supraclavicular lymph nodes was reviewed and no relation to retroperitoneal lymph node involvement was found. In 5 patients with retroperitoneal but without distant metastases, supraclavicular lymph nodes revealed tumor metastases, two of which had been clinically suspected. Depending on the staging system applied, the tumor stage had to be changed in 1 or 3 patients, respectively. For comparison, in 4 patients with distant metastases no metastatic involvement of the supraclavicular nodes was demonstrable. It is concluded that supraclavicular tumor spread is not indicative of distant metastasis and incurability. Therefore, in these cases primary radical surgery should not be considered contraindicated.