[Residual metastases from testicular cancer. CT as a diagnostic and strategic adjuvant].

Forty-nine young males with advanced testicular cancer treated between March 1982 and June 1989 comprised a 49/588 (8%) subgroup with distant metastases to the retroperitoneum, mediastinum and lungs, and required mandatory surgery on basis of the risk for reactivation of "slumbering" malignant components in tumor tissue temporarily inactivated by chemotherapy and/or radiotherapy. Preoperative CAT-scan was carried out with the intention of mapping regional pathology related to the size, number, burden of the tumor tissue, and the occasional and prognostic ominous invasion of the great vessels. Regarding radical surgery, the positive predictive value of CAT-scan was found to be 33/34 (97%). The negative predictive value was 5/15 (33%) and was interpreted as an expression of the radiologist's cautious assessment. 14/49 (29%) died before March 1990. Poor prognosis was related to invasion of major vessels and was found in 14 patients of whom eight died. It seems established that CAT-scan presents an extremely valuable preoperative investigation when it comes to planning of surgical strategy in a patient population with testicular cancer metastases with difficult access.