Phase II Trial of Retroperitoneal Lymph Node Dissection as First-line Treatment for Testicular Seminoma with Isolated Retroperitoneal Disease
Standard treatment for seminoma type germ cell tumors of testis presenting as stage IIA or as stage I with subsequent progression to isolated retroperitoneal recurrence includes external beam radiotherapy (XRT) or systemic chemotherapy (CT). Though these treatments are efficacious, with five-year relapse-free survival upwards of 90%, they are associated with significant long-term morbidity. These morbidities can be significant and the effects are often accentuated given the long life expectancy of testicular cancer survivors.
Though modification of current strategies may mitigate the risks of treating advanced seminoma, a change in treatment paradigm may be necessary to make a more significant impact. For this reason, we are proposing investigating retroperitoneal lymph node dissection (RPLND) as a first-line treatment for testicular seminoma with isolated, low-volume retroperitoneal disease.