Supraclavicular node biopsy in staging of testicular carcinoma

The supraclavicular lymph nodes are known as a potential site for metastatic disease of the gastrointestinal and genitourinary cancers. The values of supraclavicular node biopsy in patients undergoing staging for testicular cancer were studied prospectively. Of 108 patients with testicular cancer undergoing therapy, 26 had supraclavicular node biopsy as part of their staging procedure. Evidence of metastatic disease to the supraclavicular nodes was found in 36% (10/26) of the patients. Ten of these patients had abnormal examinations of the supraclavicular fossa and nine of them (90%) had histologic evidence of metastatic disease. However, of the 16 patients with normal examination of the supraclavicular fossa, only one patient (6.3%) presented with clinically inapparent metastatic disease. The low yield for detection of clinically inapparent metastatic disease mitigates against indiscriminate supraclavicular node biopsy in the staging of testicular carcinoma.