Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Viewpoint
  • Published:

Mapping studies and modified templates in nonseminomatous germ cell tumors

Nature Clinical Practice Urology volume 4, pages 60–61 (2007)Cite this article

The 5-year survival rate of patients with testicular cancer has increased dramatically, from approximately 60% in the 1960s to over 95% at present. Given the current high probability of cure, emphasis has been placed on reducing the toxicity of treatment and on preserving quality of life. In testing the lower bounds of therapeutic efficacy, and by conducting prospective, randomized trails, medical oncologists have successfully developed less toxic, but equally effective, chemotherapy regimens for testicular cancer that have stood the test of time.

By contrast, sequential modifications of retroperitoneal surgical templates have been based on mapping studies, rather than on controlled trials. Emerging data on the incidence of late relapse and repeat surgery highlight the shortcomings of this less rigorous approach, and make it clear that the liberal application of cisplatin-based chemotherapy will not compensate for suboptimal initial surgery.1,2,3 These data mandate a thoughtful re-examination of the concept of modified templates for retroperitoneal lymph node dissection (RPLND).

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

  1. McKiernan JM et al. (2003) Reoperative retroperitoneal surgery for nonseminomatous germ cell tumor: clinical presentation, patterns of recurrence, and outcome. Urology 62: 732–736

    Article  Google Scholar 

  2. Sharp DS et al. (2006) Clinical outcome of patients managed for late relapse of germ cell tumor [abstract #4550]. J Clin Oncol 24: 18S

    Article  Google Scholar 

  3. Donohue JP et al. (1998) Integration of surgery and systemic therapy: results and principles of integration. Semin Urol Oncol 16: 65–71

    CAS  PubMed  Google Scholar 

  4. Sheinfeld J et al. (2000) Surgery of testicular tumors. In Campbell's Urology, 2920–2944 (Eds Walsh PC et al.) Philadelphia: WB Saunders

    Google Scholar 

  5. Stephenson AJ and Sheinfeld J (2004) The role of retroperitoneal lymph node dissection in the management of testicular cancer. Urol Oncol 22: 225–233

    Article  Google Scholar 

  6. Eggener SE et al. (2006) Incidence and predictors of disease outside a modified retroperitoneal lymph node dissection template in clinical stage (CS) I-IIA nonseminomatous germ cell testicular cancer [abstract #594]. J Uro1 175: 4S

    Google Scholar 

  7. Ray B et al. (1974) Proceedings: Distribution of retroperitoneal lymph node metastases in testicular germinal tumors. Cancer 33: 340–348

    Article  CAS  Google Scholar 

  8. Donohue JP et al. (1982) Distribution of nodal metastases in nonseminomatous testis cancer. J Urol 128: 315–320

    Article  CAS  Google Scholar 

  9. Weissbach L and Boedefeld EA (1987) Localization of solitary and multiple metastases in stage II nonseminomatous testis tumor as basis for a modified staging lymph node dissection in stage I. J Urol 138: 77–82

    Article  CAS  Google Scholar 

  10. Carver BS et al. (2006) The incidence and implications of disease outside a modified template in men undergoing postchemotherapy retroperitoneal lymph node dissection (PC-RPLND) for metastatic non-seminomatous germ cell tumor (NSGCT) [abstract #593]. J Uro1 175: 4S

    Google Scholar 

Download references

Author information

Author notes

  1. Urology Service, Department of Surgery, Memorial Sloan–Kettering Cancer Center, 353 East 68th Street, New York, NY 10021, USA sheinfej@mskcc.org

Authors and Affiliations

  1. J Sheinfeld is Deputy Chief of Service of the Urology Service in the Department of Surgery at Memorial Sloan–Kettering Cancer Center and Professor of Urology in the Department of Urology of Weill College of Medicine in New York, NY, USA.,

    Joel Sheinfeld

Authors
  1. Joel Sheinfeld
    View author publications

    You can also search for this author in PubMed Google Scholar

Ethics declarations

Competing interests

The author declares no competing financial interests.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sheinfeld, J. Mapping studies and modified templates in nonseminomatous germ cell tumors. Nat Rev Urol 4, 60–61 (2007). https://doi.org/10.1038/ncpuro0730

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ncpuro0730

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing