[Is risk-oriented therapy in stage I non-seminoma tumor advisable?]

For a long time the usual regimen for patients with a non-seminomatous testicular tumor, clinical stage I, was an orchiectomy and retroperitoneal lymphadenectomy. Because of the possible loss of ejaculation as a aggravating consequence for the patient, one must think about alternatives. One of those is the wait-and-see strategy. Recurrences, which occur in 30% of the patients, 15% retroperitoneal and 15% pulmonary, can be cured with chemotherapy. Unfortunately, the recurrence is often discovered late because the uncertainty of radiological diagnostic procedures. Then several courses of inductive chemotherapy are necessary. Thus, it is worthwhile to consider primary adjuvant chemotherapy. There have been only a few reports about this strategy, but all are very hopeful. The advantages and disadvantages of the different strategies are discussed in the following paper.