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Payton S - Men with nonseminomatous germ cell tumors (NSGCTs) who are at high risk of metastasis can benefit from retroperitoneal lymph node dissection (RPLND) as primary treatment. The recent development of safer dissection techniques that reduce the risk of retrograde ejaculation add to its potential as a first-line treatment in testicular cancer. Long-term complications linked to cisplatin-based treatment include cardiovascular disease and metabolic syndrome. Secondary malignancy associated with radiation exposure during post-chemotherapy follow-up CT imaging would also be avoided by employing this management strategy.

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