Seminoma surgery

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sogand Goudarzi, MD [2]

Overview

Radical inguinal orchiectomy is the first treatment for any stage of testicular seminoma and it is usually done as part of diagnosis.

Surgery

• Surgery is usually reserved for majority of patients.The feasibility of surgery depends on the stage of seminomsat diagnosis.
• The feasibility of surgery depends on the stage of seminoma at diagnosis.
• Surgery is the mainstay of treatment for seminoma.

• Diagnose and help stage the cancer
• Completely remove the tumor
• Remove tumors that have spread to other parts of the body, such as the lungs
• Remove any residual disease

• The following are the types of surgery most commonly used to treat testicular semiono, which include:

• Radical inguinal orchiectomy
• Retroperitoneal lymph node dissection
• Salvage surgery
• Surgery for metastases

Radical Inguinal Orchiectomy

• Among patients who present with clinically advanced disease, radical orchiectomy is useful to remove the tumor prior to chemotherapy when possible.

Retroperitoneal Lymph Node Dissection

• Retroperitoneal lymph node dissection (RPLND) may be helpful for any type of seminoma that doesn’t respond to chemotherapy.
• RPLND may be helpful at the same time as orchiectomy, or it can be done later during other surgery.

Salvage Surgery

• Sometimes, seminoma doesn’t completely respond to chemotherapy given after an orchiectomy. The cancer that remains after these primary treatments is called residual disease. Surgery used to remove residual disease is called salvage surgery. If there are high levels of tumor markers in the blood, salvage surgery may be performed to remove residual disease.
• Salvage surgery may include a bilateral RPLND, if it wasn’t done during a previous surgery.

Surgery for Metastases

• Surgery may also be used to remove seminoma that has metastasized to the lung, mediastinum, brain, liver, or neck.

Surgery

• The feasibility of surgery depends on the stage of [malignancy] at diagnosis.

OR

• Surgery is the mainstay of treatment for [disease or malignancy].