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Of 8 patients who underwent delayed orchiectomy after adequate chemotherapy for metastatic testicular cancer 7 had no evidence of disease at the time of orchiectomy but 3 had residual cancer in the testis removed. The testis may be a privileged sanctuary for malignancy even during treatment with appropriate chemotherapy. Therefore, the primary tumor should be removed in patients presenting initially with metastatic disease, even if the metastases clear with treatment.
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Snow et al. (1983) studied this question.
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