Testicular cancer, histologic classification and staging, topography of lymph node metastases

From the clinical point of view, histologic classification is intended to give suggestions for therapy (therapeutic classification) and to provide the basis for an assessment of end results (prognostic classification). In adults, the essential therapeutic question is: seminoma (only seminoma) or non-seminoma? The frequency of seminoma among the germinal testicular tumours influenced by the subtlety of the histologic examination. The histologic report should include the MOSTOFI (25) classification and the prognostic group classification of DIXON and MOORE (7). Staging of testicular cancer and criteria for the comparison of treatment results are discussed. The topography of lymphatic metastases of testicular cancer was investigated. The great majority of testicular cancers metastasize regularly, i.e., primarily into the testicular lymph center and/or along the testicular vein, and only secondarily in other lymph nodes. This provides a foundation for the increasing tendency to modified bilateral retroperitioneal node dissection.