(UroToday.com) Chemotherapy or radiotherapy are standard treatments for stage II seminoma, though they are associated with significant long-term treatment-related toxicities. Long-term morbidity from chemotherapy and radiotherapy is real, as these are young patients with excellent cure rates thus potentiating cumulative toxicities. These toxicities may include cardiac events, secondary cancers (hematologic and solid tumors), metabolic syndrome, bleomycin-induced pulmonary injury, infertility, neurotoxicity, and tinnitus. Retroperitoneal lymph node dissection (RPLND) is an established treatment for testicular germ cell tumors (primary RPLND for stage I and IIA NSGCT; post-chemotherapy RPLND) but little data exists on its efficacy as a front-line treatment in early metastatic (stage II) seminoma. At the 2021 American Society of Clinical Oncology Genitourinary Cancers Symposium (ASCO GU), Dr. Sia Daneshmand presented results of the SEMS single-arm, multi-institutional (NCT02537548), phase II study of RPLND as first-line treatment for testicular seminoma with isolated retroperitoneal disease.