Introduction

Testicular cancer, the most common tumor in men between 15 and 35 years of age, evoked widespread interest because the dramatic improvement in survival mainly achieved with the combination of improved diagnostic techniques, tumor markers availability, effective chemotherapeutic regimens, and modifications of surgical techniques led to the decrease in patients mortality from more than 50% before 1970 to less than 5% in 1997 (1).

With all means of imaging techniques available currently, 25% to 30% of patients with testicular cancer will be understaged while some of these patients will be over-staged (2). Retroperitoneal lymphadenectomy is the most sensitive and specific method for testicular cancer staging and has also a therapeutic value. Because open retroperi-toneal lymph node dissection failed to cure all patients with metastatic nonseminoma-tous germ cell tumors, all our clinical stage I patients diagnosed as pathologic stage II received chemotherapy as the definitive treatment.

Open surgical retroperitoneal lymph node dissection associates with substantial morbidity with overall relapse rates up to 55% if employed as a single therapeutic measure (3,4). We have replaced open surgical retroperitoneal lymph node dissection by laparoscopic retroperitoneal lymph node dissection because it showed decreased postoperative morbidity, quicker convalescence, and improved cosmetic results. Its diagnostic accuracy equals that of the open approach (5,6). Laparoscopic retroperitoneal lymph node dissection is considered a safe method for low stage germ cell tumors with minimal invasiveness (7,8).

10 Ways To Fight Off Cancer

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