IS RISK-ORIENTED THERAPY FOR CLINICAL STA GE-I NONSEMINOMA ADVISABLE

For a long time the usual regimen for patients with a non-seminomatous testicular tumor, clinical stage I, was an orchiectomy and retroperit oneal lymphadenectomy. Because of the possible loss of ejaculation as a aggravating consequence for the patient, one must think about altern atives. 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 oft en discovered late because the uncertainty of radiological diagnostic procedures. Then several courses of inductive chemotherapy are necessa ry. Thus, it is worthwhile to consider primary adjuvant chemotherapy. There have been only a few reports about this strategy, but all are ve ry hopeful. The advantages and disadvantages of the different strategi es are discussed in the following paper.