Primary Retroperitoneal Lymph Node Dissection for Patients With Pathologic Stage II Nonseminomatous Germ Cell Tumor—N1, N2, and N3 Disease: Is Adjuvant Chemotherapy Necessary?
Thought provoking retrospective study regarding primary RPLND for stage II NSGCT. Study found that after RPLND N1-3 disease had a recurrence rate of about 20%, which flattens at years 2 to 5, and in patients who recurred all were treated successfully with chemotherapy. Adjuvant chemotherapy is preferred on the NCCN for post-RPLND patients who are pN2-N3, however this suggests close surveillance may be an option in centers with high surgical expertise.