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Intraoperative irradiation: another option for the treatment of > or = 3 cm residual mass following chemotherapy for advanced testicular seminoma.

Four patients with advanced testicular seminoma and > or = 3 cm postchemotherapy residual retroperitoneal masses underwent retroperitoneal lymph node dissection (RPLND) followed by intraoperative irradiation (IORT) to a dose of 20 Gy. The RPLND was incomplete in all cases and hence all patients received IORT. Two patients showed viable carcinoma in the resected specimen and were administered additional chemotherapy. There were no complications of IORT (bowel, ureteric, haematologic, neurogenic). All patients are alive and disease-free at a mean follow-up period of 19 months (range 10-26). IORT is an attractive treatment alternative in this situation. Further, this approach also identifies patients with viable carcinoma, who are candidates for additional chemotherapy.