A 27-years old man presents with a left testicular tumor with a 10 cm retroperitoneal lymph node mass. The treatment of choice is:: (A) Radiotherapy, (B) Immunotherapy with interferon and interleukins, (C) Left high inguinal orchiectomy plus chemotherapy, (D) Chemotherapy alone
Answer is C. Ans. (c) Left high inguinal orchiectomy plus chemotherapyGerm Cell Tumor Staging andTreatmentExtent of DiseaseSeminomaNon seminoma* Testis only, no vascular/lymphatic invasion (T1)Radiation therapyRPLND or observation* Testis only, Vascular/lymphatic invasion (T2),* Tunica albuginea (T2),* Involvement of spermatic cord (T3)* Scrotum (T4)Radiation therapyRPLNDNodes <2cmRadiation therapyRPLND or chemotherapy often followed by RPLNDNodes 2-5cmRadiation therapyRPLND+/-adjuvant chemotherapy or chemotherapy followed by RPLNDNodes >5cmChemotherapyChemotherapy, often followed by RPLNDDistant metastasesChemotherapyChemotherapy often followed surgery (biopsy or resection)