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In an epidemiologic analysis of SEER data, middle-aged patients with early-stage disease who opted for active surveillance rather than retroperitoneal lymph node dissection experienced a greater rate of second malignancy. The investigators speculate that this may relate to increased radiation exposure (multiple CT scans) and a greater likelihood of subsequent chemotherapy use.

The Risk of Surveillance vs Lymph Node Dissection in Germ Cell Cancer: The Occurrence of Second Malignancy