Lymphadenectomy and radiation therapy in malignant tumors of the testicle other than pure seminoma

The treatment techniques and results in a group of 127 patients with malignant tumors of the testicle, other than pure seminoma, seen from 1946 to 1964 at the M. D. Anderson Hospital and Tumor Institute at Houston are discussed. An 82% 3-year NED rate has been obtained in Stage I disease whether lymph-adenectomy or radical radiotherapy alone followed orchiectomy. In a small group of patients with Stage II disease, a 57% 3-year NED rate has been obtained by utilizing lymphadenectomy and radiation therapy. Local control and survival rates appear markedly improved by adding radiotherapy to lymphadenectomy when lymph nodes are positive in the surgical specimen. Failures appear to be due to distant metastases; supporting evidence for prophylactic irradiation of the mediastinum and supraclavicular area was not found.