This week's artwork was donated by Lonny, a pediatric cancer patient who received treatment at The Children's Hospital of Philadelphia . Some citations in the text of this section are followed by a level of evidence. The PDQ editorial boards use a formal ranking system to help the reader judge the strength of evidence linked to the reported results of a therapeutic strategy. Stage II seminoma Stage II seminoma is divided into bulky and nonbulky disease for treatment planning and expression of prognosis. Residual radiologic abnormalities are common at the completion of chemotherapy.
Many abnormalities gradually regress over a period of months.
Some clinicians advocate empiric radiation of residual persistent abnormalities or attempts to resect residual masses 3 centimeters or more in size. Either approach is controversial. Nevertheless, other reports indicate that size of the residual mass does not correlate well with active residual disease, most residual masses do not grow, and frequent marker and CT scan evaluation is a viable option even when the residual mass is 3 centimeters or more. Evidence favors the omission of prophylactic radiation therapy to the mediastinum and neck. Treatment of bilateral iliac lymph nodes may also not be necessary.