Results of testicular tumour management bases on lymphographic staging

The results of the treatment of germ tumours of the testis between 1968 and 1975 are presented and assessed in relation to lymphographic staging. The number of patients seen was 132. The four year disease-free survival for Stage I seminoma was 100% and for Stage II 84% and for Stage I teratoma 72% and Stage II 31%. In Stage II seminoma supra diaphragmatic node metastases were only seen where node metastases had caused renal or ureteric displacement, and a case is made for selective prophylactic radiotherapy above the diaphragm. There was a relapse rate of 24% in the para-aortic nodes of Stage I teratomas where prophylactic irradiation was not given, suggesting a high incidence of occult metastases.