**Core Concept**
The management of non-seminomatous testicular cancer with retroperitoneal lymph node involvement involves a combination of surgery, chemotherapy, and radiation therapy. The choice of treatment depends on the extent of lymph node involvement and the presence of any metastatic disease.

**Why the Correct Answer is Right**
In a case with more than 4 retroperitoneal lymph nodes involved, the standard treatment is a combination of surgery (retroperitoneal lymph node dissection - RPLND) and chemotherapy. RPLND is performed to remove the involved lymph nodes, while chemotherapy is used to treat any potential microscopic disease. Radiation therapy is not typically used as a primary treatment for non-seminomatous testicular cancer.

**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because surveillance is not an appropriate treatment for non-seminomatous testicular cancer with more than 4 retroperitoneal lymph nodes involved. Active treatment is required to prevent further disease progression.

**Option B:** This option is incorrect because RPLND is a standard treatment for non-seminomatous testicular cancer with retroperitoneal lymph node involvement, whereas chemotherapy is used in addition to surgery.

**Option C:** This option is incorrect because chemotherapy is a standard treatment for non-seminomatous testicular cancer with retroperitoneal lymph node involvement, whereas radiation therapy is not typically used as a primary treatment.

**Clinical Pearl / High-Yield Fact**
It is essential to remember that the management of testicular cancer is highly dependent on the histological subtype and the extent of disease. A thorough understanding of the disease process and the available treatment options is crucial for making informed decisions.

**Correct Answer: A. Surveillance**