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Philip Rubin, MD

JAMA. 1970;213(1):104-106.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

The concept of curability of testicular tumors is focused in the management of the regional retroperitoneal lymph nodes. The first tenet is the predictability of spread to regional lymph nodes. The second tenet is the barrier function of lymph nodes which effectively filter and trap tumor cells, delaying spread into the blood stream via the thoracic duct. By definition, the patient with a favorable prognosis is one who has metastatic disease confined to the regional lymph nodes. It follows that the critical strategem for cure is the successful ablation of these nodes.

The lymph node barrier has been the basis for elective dissections or prophylactic irradiation of regional lymph nodes in the management of many primary cancers. The proof of its existence has been inferred from clinical observations. However, reassessment of survival figures related to elective treatment of regional nodes is subject to much argument; one need only refer to . . . [Full Text PDF of this Article]

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