This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Surgery
[{'content': 'Stage I seminoma testis, t/t of choice is \nSelect and explain. \nA. high inguinal orchidectomy, B. high inguinal orchidectomy & radiotherapy, C. radiotherapy and chemotherapy, D. trans-scrotal orchidectomy', 'role': 'user'}, {'content': "Answer: B \nExplanation: Ans. is 'b' i.e. high inguinal orchidectomy & radiotherapy Testicular Cancer - is mainly of two types - Germ cell tumors (GCT) 95% - Non germinal neoplasms -- 5% (includes leydig cells, seoli cells, gonadoblastoma) Germ cell tumors are of 2 types Seminomas (More common, better prognosis) Nonseminomas i.e. - Embryonal Ca Teratoma Choriocarcinoma Yalk sac (Endodermal sinus) Carcinoma Germ Cell Tumor Staging and Treatment Treatment Stage Extent of Disease Seminoma Nonseminoma IA Testis only, no vascular/ lymphatic invasion (TI) Radiation therapy RPLND or observation IB Testis only, with vascular/ lymphatic invasion (T2), or extension through tunica albuginea (T2), or involvement of spermatic cord (T3) or scrotum (T4) Radiation therapy RPLND HA Nodes <2 cm Radiation therapy RPLND or chemotherapy often followed by RPLND BE Nodes 2-5 cm Radiation therapy RPLND +/- adjuvant chemotherapy or chemotherapy followed by RPLND IIC Nodes >5 cm Chemotherapy Chemotherapy, often followed by RPLND III Distant metastases Chemotherapy Chemotherapy, often followed by surgery (biopsy or resection) RPLND : retroperitoneal lymph node dissection Extra gonadal Germ cell tumors --> Infrequently GCTs arise from an extra gonadal site. They have poor prognosis. They are treated by chemotherapy.", 'role': 'assistant'}]