Management of residual masses in testicular germ cell tumors

Expert Rev Anticancer Ther. 2019 Apr;19(4):291-300. doi: 10.1080/14737140.2019.1580146. Epub 2019 Feb 22.


About 50% of all patients with advanced testicular cancer demonstrate residual retroperitoneal or extraretroperitoneal masses. About two thirds of the masses harbour necrosis/fibrosis only whereas as about 10% and 40% harbour vital cancer or teratoma. Appropriate therapy will result in a high cure rate if performed properly. Areas covered: This review article covers the indication, the surgical technique and the oncological outcome of PC-RPLND and resection of extraretroperitoneal residual masses following chemotherapy in patients with advanced testis cancer. Expert commentary: Postchemotherapy retroperitoneal lymph node dissection (PC-RPLND) plays an integral part of the multimodality treatment in patients with advanced testicular germ cell tumours. Patients with nonseminomas, residual masses < 1cm and good prognosis can undergo active surveillance. In all other cases, PC-RPLND with or without resection of adjacent organs needs to be performed for curative intent. PC-RPLND requires a complex surgical approach and should be performed in experienced, tertiary referral centres only.

Keywords: Testis cancer; chemotherapy; mature teratoma; metastases; nerve-sparing surgery; nonseminomas; seminoma.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents / administration & dosage
  • Combined Modality Therapy
  • Humans
  • Lymph Node Excision
  • Male
  • Neoplasms, Germ Cell and Embryonal / pathology
  • Neoplasms, Germ Cell and Embryonal / therapy*
  • Prognosis
  • Retroperitoneal Neoplasms / pathology
  • Retroperitoneal Neoplasms / secondary
  • Retroperitoneal Neoplasms / therapy*
  • Testicular Neoplasms / pathology
  • Testicular Neoplasms / therapy*


  • Antineoplastic Agents

Supplementary concepts

  • Testicular Germ Cell Tumor