Seminoma surgery

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

Surgery is the mainstay of treatment for seminoma. The feasibility of surgery depends on the stage of seminoma at diagnosis which include: radical inguinal orchiectomy, retroperitoneal lymph node dissection, salvage surgery and surgery for metastases.

• Surgery is usually reserved for majority of patients.The feasibility of surgery depends on the stage of seminomsat diagnosis.^[1][2][3]
• The feasibility of surgery depends on the stage of seminoma at diagnosis.
• Surgery is the mainstay of treatment for seminoma which include:^[4][5][6][7]

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

• 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 (RPLND) may be helpful for any type of seminoma that doesn’t respond to chemotherapy.^[7]
• RPLND may be helpful at the same time as orchiectomy, or during other surgery.^[8]

• Among patient who dose not response to chemotherapy after orchiectomy the surgery used to remove residual disease is called salvage surgery.^[9][10]
• Salvage surgery may include a bilateral RPLND.^[11]

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

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