Retroperitoneal Lymph Node Dissection in Treating Patients With Testicular Seminoma

Inclusion Criteria:

   - Pure seminoma after orchiectomy presenting with isolated retropreritoneal
   lymphadenopathy OR stage I pure seminoma with isolated retroperitoneal relapse.
   Relapse should be within 3 years

   - Lymphadenopathy in the retroperitoneum: at least one lymph node 1-3 cm in greatest
   dimension, no lymph node > 3 cm in greatest dimension, no more than 2 lymph nodes 1-3
   cm in greatest dimension

      - Axial imaging of lymphadenopathy within 6 weeks of the date of RPLND

      - Retroperitoneal lymphadenopathy must be within the RPLND template

   - If there is borderline lymphadenopathy, defined as the largest retroperitoneal lymph
   node measuring 0.90 - 0.99 cm in the greatest dimension, an abdominal computed
   tomography (CT) scan should be repeated (recommend interval of 6 - 8 weeks); the same
   lymph node must demonstrate growth to >= 1.0 cm in the greatest dimension

   - Biopsy is not required, though if biopsy of the retroperitoneal node(s) was obtained,
   pathology must be consistent with pure seminoma

   - Chest imaging (x-ray, CT or magnetic resonance imaging [MRI]) negative for metastasis
   no more than 6 weeks prior to the date of RPLND

   - Primary tumor excised by radical inguinal orchiectomy and pathology consistent with
   pure seminoma

   - Serum alpha fetoprotein (AFP) not more than 1.5 times upper limit of normal,
   beta-human chorionic gonadotropin (HCG), lactate dehydrogenase (LDH) (per the local
   laboratory assay) within 14 days of RPLND

   - Eastern Cooperative Oncology Group (ECOG) performance status =< 1

   - Ability to understand and the willingness to sign a written informed consent

   - Serum coagulation studies (INR/PTT) and platelet counts suitable for surgery per
   surgeon discretion.

Exclusion Criteria:

   - Second primary malignancy

   - History of receiving chemotherapy or radiotherapy

   - Patients receiving any other investigational agent (s)

   - Uncontrolled intercurrent illness including, but not limited to, ongoing or active
   infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac
   arrhythmia, or psychiatric illness/social situations that would limit compliance with
   study requirements