OBJECTIVE: Herein we report our experience in pts with advanced testicular cancer treated with chemotherapy followed by salvage retroperitoneal lymph node dissection (RPLND). MATERIALS: Between January 1984 and December 1994, 89 pts, with a median age of 25,7 years, with advanced testicular cancer (stages IIB, IIC, and III) were evaluated at our Institution. These pts received systemic chemotherapy followed by salvage RPLND. RESULTS: Seminoma was present in 22 cases (24,7%) and nonseminoma tumors in 67 pts (75.3%). Fourty-four pts (49%) had pT2-pT3 primary tumors, and 28 pts (31,4%) present with distant metastasis (lungs in 8 pts [9%] and supraclavicular lymph node in 20 [22,5%]). At RPLND, 48% of the resected masses were larger than 5 cm. Histopathologic study of the specimen revealed necrosis and/or fibrosis in 60,2%, teratoma in 20,5% and viable tumor in 19,3%. Residual disease in the lungs was present in 8 cases, of which 70% had necrosis and/or fibrosis at surgical excision. In 18 pts, a second exploratory laparotomy after rescue chemotherapy was carried out: in 7 (38,9%) necrosis and/or fibrosis was found, and in 11 (61,1%) viable tumor was found. Overall surgical morbidity and mortality rates were 15,9% and 3,7%, respectively The actuarial 2 years survival, as well as 5 years survival was 81,07%. CONCLUSIONS: Our study suggests that salvage RPLND after chemotherapy is necessary, since we found viable tumor and teratoma in 40% of our cases. Our surgical mortality rate is similar to that described in the literature.