Orchiectomy only for clinical stage I nonseminomatous germ cell testis tumors: comparison with pathologic stage I...

Twenty-three men with nonseminomatous germ cell tumors confined within the tunica albuginea of the testis and negative metastatic evaluation were placed on surveillance after radical orchiectomy. Metastatic disease developed in 3 for a relapse rate of 13 percent. During the same period, 17 men with pathologic Stage I disease were followed up in the same manner, and metastatic disease developed in 3 for a relapse rate of 18 percent. All six men were treated with either combination chemotherapy or retroperitoneal lymphadenectomy, and all are alive without disease for at least two years from end of therapy. If strict criteria are followed, surveillance has a place in the management of carefully selected young men with clinical Stage I disease.