Comparison of clinical and histopathologic diagnosis for early stages of advanced nonseminomatous germ cell testicular tumors

: The authors present their observations concerning application of imaging methods in disease staging procedures in 69 patients with low stage nonseminomatous germ cell testicular tumors (NSGCTT). The results of CT, USG, and lymphangiography examinations of the retroperitoneal lymph nodes were compared with the results of pathological examination of these nodes, removed during retroperitoneal lymphadenectomy. 29 patients had clinical stage I (no node involvement) and 40 patients had stage II disease (node metastases). After lymphadenectomy, in 31% of the patients, diagnosed clinically as stage I, the preliminary diagnosis was found to be false negative, and in 13.5% of the patients, diagnosed clinically as stage II, the preliminary diagnosis was found to be false positive. We assessed the value of the imaging methods by calculating the accuracy, the sensitivity and the specificity of each of them. The results are, respectively: 81%, 76% and 57% for CT; 79%, 76% and 51% for USG; and 77%, 77%, and 69% for lymphangiography. The authors conclude that retroperitoneal lymphadenectomy allows establishing of the most precise diagnosis and appropriate treatment in patients with nonseminomatous germ cell testicular tumors.