Specific treatment of malignant germ cell tumors of the testis following inguinal orchiectomy is predicated on histologic type and stage of involvement. A review of 839 patients treated at Walter Reed General Hospital has shown a 60% overall 10‐year survival. With seminomas, treatment by orchiectomy and irradiation to lymphatic drainage pathways can result in cure rates of 90‐95%. The proper treatment of testicular carcinoma is far from settled. The mainstay of such treatment in the U.S. has been retroperitoneal lymphadenectomy followed by irradiation for positive nodes. However, it is still not clear whether irradiation might not be equal or superior to lymphadenectomy in early disease. Bilateral lymphadenectomy has shown no advantage over unilateral lymphadenectomy with positive metastases when postoperative irradiation has been administered. Preoperative irradiation and lymphadenectomy show promise for testicular carcinoma, but investigation along such lines is limited thus far to small numbers of cases and a relatively short duration of followups. Prospective national studies for testis carcinoma are clearly needed.
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