What are the treatment choices for stage I nonseminoma germ-cell tumors?
Following orchiectomy, stage I nonseminoma germ-cell tumors (NSGCTs) are usually treated with additional surgery (RPLND), chemotherapy, or watchful waiting. NSGCTs are rarely treated with radiation therapy. • Retroperitoneal lymph node dissection (RPLND) is surgery to remove lymph nodes in the lower back and pelvis that may be cancerous. During the early phases of stage I nonseminoma testicular cancer, it can be very difficult to tell whether these lymph nodes are cancerous without surgically removing them first. In the past, RPLND was associated with high rates of infertility. Modern “nerve-sparing” and laparoscopic surgical techniques have lowered the chances of becoming infertile following RPLND. • Chemotherapy. Chemotherapy is the use of very powerful medicines to kill cancer cells. The most common chemotherapy used to treat nonseminoma testicular cancer is called cisplatin combination therapy and involves the use of several different medicines. This treatment varies in intensity a
