The management of subcentimeter residual mass in NSGCT: pcRPLND vs. observation

Patients with advanced non-seminomatous germ cell tumors may achieve a serologic and radiographic complete response (CR) to first-line chemotherapy (defined as a residual mass < 1 cm in size). Recent reports suggest that these patients may be observed with a low rate of relapse but there remain compelling arguments for surgical excision. The arguments for and against post-chemotherapy retroperitoneal lymph node dissection (pcRPLND) are presented. There is clear consensus that patient's with residual masses > 1 cm should undergo post-chemotherapy surgery.