Retroperitoneal lymph node dissection for the management of clinical stageI nonseminoma

Purpose: We review the rationale for the use of retroperitoneal lymph node dissection for clinical stage I nonseminomatous testis cancer. Materials and Methods: The published literature regarding the alternative t reatments for clinical stage I nonseminoma was reviewed as well as the pers onal experience of the authors to define the role of retroperitoneal lymph node dissection. Results: Retroperitoneal lymph node dissection alone is curative in 50% to 75% of patients with pathological stage II disease. The only significant lo ng-term morbidity is a 1% chance of small bowel obstruction. If recurrence develops after retroperitoneal lymph node dissection, it is virtually alway s curable with cisplatin based chemotherapy. Conclusions: Retroperitoneal lymph node dissection retains a therapeutic an d staging capability in these patients. The probability for cure, short and long-term morbidity, and minimal need for long-term followup in these pati ents indicates that retroperitoneal lymph node dissection continues to be s tandard therapy for clinical stage I nonseminoma.