Retroperitoneal lymph node dissection for early metastatic testicular seminoma with limited retroperitoneal lymphadenopathy

Survivors of metastatic testicular seminoma can suffer long-term toxicities from radiotherapy or systemic chemotherapy. The phase 2 SEMS trial (‘Surgery in Early Metastatic Seminoma’), at twelve centers in the US and Canada, evaluated first-line retroperitoneal lymph node dissection (RPLND) for testicular seminoma with clinically low-volume retroperitoneal lymphadenopathy. At two years, 81% of patients were recurrence-free. The long-term morbidity was low. The authors conclude that RPLND is a treatment option in this setting.