Defending the EAU 2010 Guidelines on Testis Cancer: Nerve-sparing Retroperitoneal Lymphadenectomy Is Not a Primary Treatment Option for Stage I Nonseminoma

The final outcome of RPLND is comparable to surveillance or risk-adapted management, but an overtreatment rate of 70%, the necessity of limiting the procedure to specialised centres to avoid inappropriate resections, and long-term sequelae as well as the highest overall burden of treatment are strong arguments against its use as a primary treatment option.