How do you decide between RPLND vs. chemotherapy in patients with Stage IIA mixed germ cell tumor as primary treatment?  

CSIIA nonseminoma is not as straightforward as many people think although it is a common clinical scenario in the days of active surveillance in CSI GCTs. A very germane aspect is that probably 20% of clinical IIA GCTs are false positive (when confirmed by pathologic assessments) which means if you ...

I agree but would add a few comments: If there is a rising hCG or AFP above normal values, we prefer BEP X 3 rather than RPLND. If the patient > age 50, EP X 4. Also, we consider any AFP < 25 to be “ normal” despite many labs listing  0-8 as their normal range. Our group r...

If there is teratoma in primary testis cancer and markers are not elevated then prefer RPLND.