How would you treat a patient with history of stage I seminoma s/p orchiectomy with enlarging periaortic node and normal tumor markers on surveillance?  

Would you biopsy lymph node to confirm recurrence/histology? 

If confirmed, how do you decide between RT vs chemotherapy? If chemo - BEP x3 vs EP x4?

Does time to recurrence (e.g. <1 year), number of nodes (1 vs many) or size inform your decision? 

Any role for germline testing?



Answer from: Radiation Oncologist at Academic Institution

Answer from: Medical Oncologist at Community Practice

Answer from: Medical Oncologist at Community Practice

Answer from: Radiation Oncologist at Community Practice