Testicular cancer is the most common solid tumor in young men, with approximately 10,000 diagnoses in the U.S. each year.

New treatments are always in development, often with the goal of less open surgery, but a new analysis of 165 patients with clinical stage I or II testicular cancer and no prior chemotherapy in the Indiana University Testicular Cancer database found that the conventional open surgery approach, removing lymph nodes behind the intestines for patients whose testicular cancer is still only in the abdomen remains the best standard of care. Robot-assisted care may allow a more complete lymph node dissection there wasn't enough data for a valid comparison.

Traditional open surgery - an incision on the abdomen and direct access to the surgical area - had excellent cure rates, especially if performed at high-volume centers. Benchmarks included low blood loss, short hospital stay and risk factors for postoperative complications.


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“For this study, I wanted to know that this and other treatments I perform are making a difference and I want to know -- whether we are continuing established treatments or introducing new approaches to surgery -- how these decisions and the resulting care will impact patients’ quality of life and their cancer outcomes," said Dr. Clint Cary, M.D., MPH, MBA, of the Indiana University School of Medicine. “This study is an example of how the benefit of providing clinical care and also being in a research environment enables us to learn from what we're doing and to report it in a manner that is meaningful to both patients and physicians. We're always looking for ways to improve upon surgical outcomes. Going beyond the scope of this paper, we are now expanding our work to begin a randomized trial comparing two surgical techniques for removing lymph nodes to understand if one is better than the other regarding postoperative recovery.”

The authors conclude that for patients undergoing removal of lymph nodes for testicular cancer and certainly more complex and challenging patients at higher risk of post-operative complications, the traditional open surgery remains the most effective approach and the gold standard.