Management of stage I testicular germ cell tumours

  title={Management of stage I testicular germ cell tumours},
  author={Michal Chovanec and Nasser H Hanna and K. Clint Cary and Lawrence H. Einhorn and Costantine Albany},
  journal={Nature Reviews Urology},
Clinical stage I testicular germ cell tumours (TGCT) are highly curable neoplasms. The treatment of stage I testicular cancer is complex and requires a multidisciplinary approach. Standard options after radical orchiectomy for seminoma include active surveillance, radiation therapy or 1–2 cycles of carboplatin, and options for nonseminoma include active surveillance, retroperitoneal lymph node dissection (RPLND) or 1–2 cycles of bleomycin plus etoposide plus cisplatin (BEP). All the options… 
Adjuvant Therapy for Stage IB Germ Cell Tumors: One versus Two Cycles of BEP
The factors to be considered when adopting a risk-adapted strategy for giving adjuvant chemotherapy in Stage 1B NSGCTs are reviewed and the data regarding the number of BEP cycles to administer is discussed.
New treatments for stage I testicular cancer.
In the absence of a predictive biomarker for recurrence, active surveillance avoids overtreatment in 50% to 85% of patients, with no risk of long-term side effects in nonrelapsing patients and a preserved overall survival of almost 100% after specific treatment for recurrent disease.
Testicular Cancer, Version 2.2020, NCCN Clinical Practice Guidelines in Oncology.
Recommendations for the management of adult patients with nonseminomatous GCTs, the most common solid tumor in men between the ages of 20 and 34 years, are focused on.
Treatment of germ cell testicular cancer
This review will focus on treatment strategies of primary GCTC, a malignant neoplasm derived from the primordial germ cell that is the most common cancer of younger male population, with the highest incidence between ages 15 and 35.
Systemic therapy for primary and extragonadal germ cell tumors: prognosis and nuances of treatment.
The staging and risk classification oftesticular cancers is outlined, and the current state of knowledge and standard of care for the systemic treatment of testicular germ cell tumors with chemotherapy is reviewed, focusing on the relevant clinical data supporting each treatment regimen.
Systemic Therapies in the Management of Testicular Cancers
The aim of this chapter is to summarize systemic therapies for testicular cancer especially GCTs.
Clinical characteristics of testicular seminoma in individuals in West China: a 10-year follow-up study
The present study shows that patients with TS have good prognosis even at an advanced stage, and it is recommended cisplatin-based chemotherapy as salvage therapy for patients with CSI seminoma.
Pathological predictors of metastatic disease in testicular non-seminomatous germ cell tumors: which tumor-node-metastasis staging system?
Lymphovascular invasion, stromal rete testis invasion, tumor size, and embryonal carcinoma percentage are strong predictors of metastatic disease at presentation and their inclusion should be considered in any future TNM revision.


The management strategies for stage I seminoma.
Management of patients with clinical stage I nonseminomatous testicular germ cell tumours: active surveillance versus primary chemotherapy versus nerve sparing retroperitoneal lymphadenectomy.
There seems to be a consensus that active surveillance is the treatment strategy of choice for CS I low risk patients and there is no clear cut recommendation in high risk patients, but each treatment has its own advantages and disadvantages.
Management options for stage I seminoma
Although this model needs to be improved and validated, active close surveillance for low-risk patients and adjuvant therapy for those uncompliant or at higher risk of relapse seem to be acceptable options for patients with stage I seminoma.
Risk-adapted treatment in clinical stage I nonseminomatous germ cell testicular cancer: the SWENOTECA management program.
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One course of adjuvant BEP reduces the risk of relapse by approximately 90% in both VASC+ and VASC- CS1NSGCT, and may be a new option as initial treatment for all CS1 NSGCT.
Stage I nonseminomatous germ-cell testicular cancer — management options and risk-benefit considerations
These consistent results reported for two eras (pre- and postplatinum) spanning a period of 25 years suggest a sound basis for the surgical approach with primary retroperitoneal lymph-node dissection (RPLND), and it would seem appropriate to have nerve-sparing RPLND techniques in any armamentarium dealing with clinical stage A disease.
Testicular seminoma clinical stage 1: treatment outcome on a routine care level
Unexpectedly, the risk factors in surveillance patients were not confirmed, but tumor size proved to be a risk indicator in the entire group of seminoma, and the overall outcome of CS1 seminoma managed on the routine care level mirrors that of controlled trials.