What is the appropriate management of Stage 0 (testicular intratubular neoplasia) of the testicle?  

Is there any advantage to primary RT as opposed to just orchiectomy? Additionally, in order to confirm Tis, a biopsy is required, which is typically ill-advised prior to surgery in locally advanced seminoma as it increases the relapse rate. Would this not lead one to recommend a  radical inguinal orchiectomy as opposed to definitive RT?

 



Answer from: Radiation Oncologist at Community Practice