[The T category and metastasis in testicular tumors]

On the background of the advantageous prognosis of patients with testicular tumors we define subgroups in which therapy can be reduced. Basing on the distribution of metastases, especially the localisation of solitary nodes, staging LA may be limited to certain regions in patients with non-seminomas. The modification of irradiation fields for seminomas is difficult as the predictive value of negative diagnoses (CT, sonography, lymphography) is only 77%. As the topography of metastases does not differ within the various T-categories, the necessary extent of irradiation cannot be related upon them. In clinical stage I contralateral iliacal fields have not to be included. In left-sided tumors no positive solitary nodes were found in the ipsilateral iliac region, subsequently we suppose that this area might be preserved. In right-sided tumors occasional solitary nodes in the ipsilateral field are not necessarily due to an infiltration of the epididymis; therefore we recommend in general a prophylactic irradiation of the ipsilateral iliac region. An inguinal irradiation should be reserved only for pre-operated patients and an involvement of the scrotal wall.