Germ cell tumors (GCTs) account for 95% of testicular cancers. Testicular GCTs constitute the most common solid tumor in men between the ages of 20 and 34 years, and the incidence of testicular GCTs has been increasing in the past 2 decades. Testicular GCTs are classified into 2 broad groups—pure seminoma and nonseminoma—which are treated differently. Pure seminomas, unlike nonseminomas, are more likely to be localized to the testis at presentation. Nonseminoma is the more clinically aggressive tumor associated with elevated serum concentrations of alphafetoprotein (AFP). The diagnosis of a seminoma is restricted to pure seminoma histology and a normal serum concentration of AFP. When both seminoma and elements of a nonseminoma are present, management follows that for a nonseminoma. The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Testicular Cancer outline the diagnosis, workup, risk assessment, treatment, and follow-up schedules for patients with both pure seminoma and nonseminoma.

  • 1.

    Siegel RL, Miller KD, Jemal A. Cancer statistics, 2015. CA Cancer J Clin 2015;65:529.

  • 2.

    National Cancer Institute. SEER Stat Fact Sheets: Testis Cancer. Available at http://seer.cancer.gov/statfacts/html/testis.html. Accessed May 28, 2015.

    • Search Google Scholar
    • Export Citation
  • 3.

    Huyghe E, Matsuda T, Thonneau P. Increasing incidence of testicular cancer worldwide: a review. J Urol 2003;170:511.

  • 4.

    Shanmugalingam T, Soultati A, Chowdhury S. Global incidence and outcome of testicular cancer. Clin Epidemiol 2013;5:417427.

  • 5.

    Verhoeven RH, Gondos A, Janssen-Heijnen ML. Testicular cancer in Europe and the USA: survival still rising among older patients. Ann Oncol 2013;24:508513.

    • Search Google Scholar
    • Export Citation
  • 6.

    Chia VM, Quraishi SM, Devesa SS. International trends in the incidence of testicular cancer, 1973-2002. Cancer Epidemiol Biomarkers Prev 2010;19:11511159.

    • Search Google Scholar
    • Export Citation
  • 7.

    Bosl GJ, Motzer RJ. Testicular germ-cell cancer. N Engl J Med 1997;337:242253.

  • 8.

    Turnbull C, Rahman N. Genome-wide association studies provide new insights into the genetic basis of testicular germ-cell tumour. Int J Androl 2011;34:e86-96; discussion e96–87.

    • Search Google Scholar
    • Export Citation
  • 9.

    Greene MH, Kratz CP, Mai PL. Familial testicular germ cell tumors in adults: 2010 summary of genetic risk factors and clinical phenotype. Endocr Relat Cancer 2010;17:R109121.

    • Search Google Scholar
    • Export Citation
  • 10.

    Nazeer T, Ro JY, Amato RJ. Histologically pure seminoma with elevated alpha-fetoprotein: a clinicopathologic study of ten cases. Oncol Rep 1998;5:14251429.

    • Search Google Scholar
    • Export Citation
  • 11.

    Weissbach L, Bussar-Maatz R, Mann K. The value of tumor markers in testicular seminomas. Results of a prospective multicenter study. Eur Urol 1997;32:1622.

    • Search Google Scholar
    • Export Citation
  • 12.

    Kim W, Rosen MA, Langer JE. US MR imaging correlation in pathologic conditions of the scrotum. Radiographics 2007;27:12391253.

  • 13.

    Klein EA. Tumor markers in testis cancer. Urol Clin North Am 1993;20:6773.

  • 14.

    Ragni G, Somigliana E, Restelli L. Sperm banking and rate of assisted reproduction treatment: insights from a 15-year cryopreservation program for male cancer patients. Cancer 2003;97:16241629.

    • Search Google Scholar
    • Export Citation
  • 15.

    Saito K, Suzuki K, Iwasaki A. Sperm cryopreservation before cancer chemotherapy helps in the emotional battle against cancer. Cancer 2005;104:521524.

    • Search Google Scholar
    • Export Citation
  • 16.

    Brydoy M, Fossa SD, Klepp O. Paternity following treatment for testicular cancer. J Natl Cancer Inst 2005;97:15801588.

  • 17.

    Huyghe E, Matsuda T, Daudin M. Fertility after testicular cancer treatments: results of a large multicenter study. Cancer 2004;100:732737.

  • 18.

    Gordon W Jr., Siegmund K, Stanisic TH. A study of reproductive function in patients with seminoma treated with radiotherapy and orchidectomy: (SWOG-8711). Southwest Oncology Group. Int J Radiat Oncol Biol Phys 1997;38:8394.

    • Search Google Scholar
    • Export Citation
  • 19.

    Jones RH, Vasey PA. Part I: testicular cancer--management of early disease. Lancet Oncol 2003;4:730-737.

  • 20.

    Fossa SD, Chen J, Schonfeld SJ. Risk of contralateral testicular cancer: a population-based study of 29,515 U.S. men. J Natl Cancer Inst 2005;97:10561066.

    • Search Google Scholar
    • Export Citation
  • 21.

    International Germ Cell Consensus Classification: a prognostic factor-based staging system for metastatic germ cell cancers. International Germ Cell Cancer Collaborative Group. J Clin Oncol 1997;15:594603.

    • Search Google Scholar
    • Export Citation
  • 22.

    Leibovitch L, Foster RS, Kopecky KK, Donohue JP. Improved accuracy of computerized tomography based clinical staging in low stage nonseminomatous germ cell cancer using size criteria of retroperitoneal lymph nodes. J Urol 1995;154:17591763.

    • Search Google Scholar
    • Export Citation
  • 23.

    See WA, Hoxie L. Chest staging in testis cancer patients: imaging modality selection based upon risk assessment as determined by abdominal computerized tomography scan results. J Urol 1993;150:874878.

    • Search Google Scholar
    • Export Citation
  • 24.

    Mead GM, Fossa SD, Oliver RT. Randomized Trials in 2466 Patients With Stage I Seminoma: Patterns of Relapse and Follow-up. J Natl Cancer Inst 2011;103:241249.

    • Search Google Scholar
    • Export Citation
  • 25.

    Groll RJ, Warde P, Jewett MA. A comprehensive systematic review of testicular germ cell tumor surveillance. Crit Rev Oncol Hematol 2007;64:182197.

    • Search Google Scholar
    • Export Citation
  • 26.

    Aparicio J, Garcia del Muro X, Maroto P. Multicenter study evaluating a dual policy of postorchiectomy surveillance and selective adjuvant single-agent carboplatin for patients with clinical stage I seminoma. Ann Oncol 2003;14:867872.

    • Search Google Scholar
    • Export Citation
  • 27.

    Warde P, Specht L, Horwich A. Prognostic factors for relapse in stage I seminoma managed by surveillance: a pooled analysis. J Clin Oncol 2002;20:44484452.

    • Search Google Scholar
    • Export Citation
  • 28.

    Chung P, Parker C, Panzarella T. Surveillance in stage I testicular seminoma: risk of late relapse. Can J Urol 2002;9:16371640.

  • 29.

    von der Maase H, Specht L, Jacobsen GK. Surveillance following orchidectomy for stage I seminoma of the testis. Eur J Cancer 1993;29A:19311934.

    • Search Google Scholar
    • Export Citation
  • 30.

    Warde P, Gospodarowicz MK, Banerjee D. Prognostic factors for relapse in stage I testicular seminoma treated with surveillance. J Urol 1997;157:17051709; discussion 1709-1710.

    • Search Google Scholar
    • Export Citation
  • 31.

    Chung PW, Daugaard G, Tyldesley S. Prognostic factors for relapse in stage I seminoma managed with surveillance: A validation study [abstract]. J Clin Oncol 2010;28:Abstract 4535.

    • Search Google Scholar
    • Export Citation
  • 32.

    Chung P, Warde P. Stage I seminoma: adjuvant treatment is effective but is it necessary? J Natl Cancer Inst 2011;103:194196.

  • 33.

    Kollmannsberger C, Tandstad T, Bedard PL. Patterns of relapse in patients with clinical stage I testicular cancer managed with active surveillance. J Clin Oncol 2015;33:5157..

    • Search Google Scholar
    • Export Citation
  • 34.

    Cohn-Cedermark G, Stahl O, Tandstad TSwenoteca. Surveillance vs. adjuvant therapy of clinical stage I testicular tumors: a review and the SWENOTECA experience. Andrology 2015;3:102110.

    • Search Google Scholar
    • Export Citation
  • 35.

    Oliver RT, Mason MD, Mead GM. Radiotherapy versus single-dose carboplatin in adjuvant treatment of stage I seminoma: a randomised trial. Lancet 2005;366:293300.

    • Search Google Scholar
    • Export Citation
  • 36.

    Oliver RT, Mead GM, Rustin GJ. Randomized trial of carboplatin versus radiotherapy for stage I seminoma: mature results on relapse and contralateral testis cancer rates in MRC TE19/EORTC 30982 study (ISRCTN27163214). J Clin Oncol 2011;29:957962.

    • Search Google Scholar
    • Export Citation
  • 37.

    Aparicio J, Germa JR, Garcia del Muro X. Risk-adapted management for patients with clinical stage I seminoma: the Second Spanish Germ Cell Cancer Cooperative Group study. J Clin Oncol 2005;23:87178723.

    • Search Google Scholar
    • Export Citation
  • 38.

    Huddart RA, Norman A, Shahidi M. Cardiovascular disease as a long-term complication of treatment for testicular cancer. J Clin Oncol 2003;21:15131523.

    • Search Google Scholar
    • Export Citation
  • 39.

    Beard CJ, Travis LB, Chen MH. Outcomes in stage I testicular seminoma: a population-based study of 9193 patients. Cancer 2013;119:27712777.

  • 40.

    Garmezy B, Pagliaro LC. Choosing treatment for stage I seminoma: who should get what? Oncology (Williston Park) 2009;23:753, 759.

  • 41.

    Jones WG, Fossa SD, Mead GM. Randomized trial of 30 versus 20 Gy in the adjuvant treatment of stage I testicular seminoma: a report on Medical Research Council Trial TE18, European Organisation for the Research and Treatment of Cancer Trial 30942 (ISRCTN18525328). J Clin Oncol 2005;23:12001208.

    • Search Google Scholar
    • Export Citation
  • 42.

    Fossa SD, Horwich A, Russell JM. Optimal planning target volume for stage I testicular seminoma: a Medical Research Council randomized trial. Medical Research Council Testicular Tumor Working Group. J Clin Oncol 1999;17:1146.

    • Search Google Scholar
    • Export Citation
  • 43.

    Dinniwell R, Chan P, Czarnota G. Pelvic lymph node topography for radiotherapy treatment planning from ferumoxtran-10 contrast-enhanced magnetic resonance imaging. Int J Radiat Oncol Biol Phys 2009;74:844851.

    • Search Google Scholar
    • Export Citation
  • 44.

    McMahon CJ, Rofsky NM, Pedrosa I. Lymphatic metastases from pelvic tumors: anatomic classification, characterization, and staging. Radiology 2010;254:3146.

    • Search Google Scholar
    • Export Citation
  • 45.

    Martin JM, Panzarella T, Zwahlen DR. Evidence-based guidelines for following stage 1 seminoma. Cancer 2007;109:22482256.

  • 46.

    Souchon R, Hartmann M, Krege S. Interdisciplinary evidence-based recommendations for the follow-up of early stage seminomatous testicular germ cell cancer patients. Strahlenther Onkol 2011;187:158166.

    • Search Google Scholar
    • Export Citation
  • 47.

    Aparicio J, Maroto P, del Muro XG. Risk-adapted treatment in clinical stage I testicular seminoma: the third Spanish Germ Cell Cancer Group study. J Clin Oncol 2011;29:46774681.

    • Search Google Scholar
    • Export Citation
  • 48.

    Daugaard G, Petersen PM, Rorth M. Surveillance in stage I testicular cancer. APMIS 2003;111:7683; discussion 83–75.

  • 49.

    TRISST (MRC TE24) Trial of imaging and schedule in seminoma testis. Available at: http://www.ctu.mrc.ac.uk/our_research/research_areas/cancer/studies/trisst_mrc_te24/. Accessed on May 4, 2015.

    • Search Google Scholar
    • Export Citation
  • 50.

    Livsey JE, Taylor B, Mobarek N. Patterns of relapse following radiotherapy for stage I seminoma of the testis: implications for follow-up. Clin Oncol (R Coll Radiol) 2001;13:296300.

    • Search Google Scholar
    • Export Citation
  • 51.

    van As NJ, Gilbert DC, Money-Kyrle J. Evidence-based pragmatic guidelines for the follow-up of testicular cancer: optimising the detection of relapse. Br J Cancer 2008;98:18941902.

    • Search Google Scholar
    • Export Citation
  • 52.

    Classen J, Schmidberger H, Meisner C. Radiotherapy for stages IIA/B testicular seminoma: final report of a prospective multicenter clinical trial. J Clin Oncol 2003;21:11011106.

    • Search Google Scholar
    • Export Citation
  • 53.

    Patterson H, Norman AR, Mitra SS. Combination carboplatin and radiotherapy in the management of stage II testicular seminoma: comparison with radiotherapy treatment alone. Radiother Oncol 2001;59:511.

    • Search Google Scholar
    • Export Citation
  • 54.

    Schmidberger H, Bamberg M, Meisner C. Radiotherapy in stage IIA and IIB testicular seminoma with reduced portals: a prospective multicenter study. Int J Radiat Oncol Biol Phys 1997;39:321326.

    • Search Google Scholar
    • Export Citation
  • 55.

    Detti B, Livi L, Scoccianti S. Management of Stage II testicular seminoma over a period of 40 years. Urol Oncol 2009;27:534538.

  • 56.

    Choo R, Sandler H, Warde P. Survey of radiation oncologists: practice patterns of the management of stage I seminoma of testis in Canada and a selected group in the United States. Can J Urol 2002;9:14791485.

    • Search Google Scholar
    • Export Citation
  • 57.

    Gospodarwicz MK, Sturgeon JF, Jewett MA. Early stage and advanced seminoma: role of radiation therapy, surgery, and chemotherapy. Semin Oncol 1998;25:160173.

    • Search Google Scholar
    • Export Citation
  • 58.

    Domont J, Massard C, Patrikidou A. A risk-adapted strategy of radiotherapy or cisplatin-based chemotherapy in stage II seminoma. Urol Oncol 2011.

    • Search Google Scholar
    • Export Citation
  • 59.

    Garcia-del-Muro X, Maroto P, Guma J. Chemotherapy as an alternative to radiotherapy in the treatment of stage IIA and IIB testicular seminoma: a Spanish Germ Cell Cancer Group Study. J Clin Oncol 2008;26:54165421.

    • Search Google Scholar
    • Export Citation
  • 60.

    de Wit R, Roberts JT, Wilkinson PM. Equivalence of three or four cycles of bleomycin, etoposide, and cisplatin chemotherapy and of a 3- or 5-day schedule in good-prognosis germ cell cancer: a randomized study of the European Organization for Research and Treatment of Cancer Genitourinary Tract Cancer Cooperative Group and the Medical Research Council. J Clin Oncol 2001;19:16291640.

    • Search Google Scholar
    • Export Citation
  • 61.

    Loehrer PJ Sr., Johnson D, Elson P. Importance of bleomycin in favorable-prognosis disseminated germ cell tumors: an Eastern Cooperative Oncology Group trial. J Clin Oncol 1995;13:470476.

    • Search Google Scholar
    • Export Citation
  • 62.

    Saxman SB, Finch D, Gonin R, Einhorn LH. Long-term follow-up of a phase III study of three versus four cycles of bleomycin, etoposide, and cisplatin in favorable-prognosis germ-cell tumors: the Indian University experience. J Clin Oncol 1998;16:702706.

    • Search Google Scholar
    • Export Citation
  • 63.

    Bajorin DF, Sarosdy MF, Pfister DG. Randomized trial of etoposide and cisplatin versus etoposide and carboplatin in patients with good-risk germ cell tumors: a multiinstitutional study. J Clin Oncol 1993;11:598606.

    • Search Google Scholar
    • Export Citation
  • 64.

    Xiao H, Mazumdar M, Bajorin DF. Long-term follow-up of patients with good-risk germ cell tumors treated with etoposide and cisplatin. J Clin Oncol 1997;15:25532558.

    • Search Google Scholar
    • Export Citation
  • 65.

    Kondagunta GV, Bacik J, Bajorin D. Etoposide and cisplatin chemotherapy for metastatic good-risk germ cell tumors. J Clin Oncol 2005;23:92909294.

    • Search Google Scholar
    • Export Citation
  • 66.

    Tjan-Heijnen VC, Oosterhof GO, de Wit R, De Mulder PH. Treatment in germ cell tumours: state of the art. Eur J Surg Oncol 1997;23:110117.

  • 67.

    de Wit R, Louwerens M, de Mulder PH. Management of intermediate-prognosis germ-cell cancer: results of a phase I/II study of Taxol-BEP. Int J Cancer 1999;83:831833.

    • Search Google Scholar
    • Export Citation
  • 68.

    Becherer A, De Santis M, Karanikas G. FDG PET is superior to CT in the prediction of viable tumour in post-chemotherapy seminoma residuals. Eur J Radiol 2005;54:284288.

    • Search Google Scholar
    • Export Citation
  • 69.

    Hinz S, Schrader M, Kempkensteffen C. The role of positron emission tomography in the evaluation of residual masses after chemotherapy for advanced stage seminoma. J Urol 2008;179:936940; discussion 940.

    • Search Google Scholar
    • Export Citation
  • 70.

    Cremerius U, Wildberger JE, Borchers H. Does positron emission tomography using 18-fluoro-2-deoxyglucose improve clinical staging of testicular cancer?--Results of a study in 50 patients. Urology 1999;54:900904.

    • Search Google Scholar
    • Export Citation
  • 71.

    Albers P, Bender H, Yilmaz H. Positron emission tomography in the clinical staging of patients with Stage I and II testicular germ cell tumors. Urology 1999;53:808811.

    • Search Google Scholar
    • Export Citation
  • 72.

    Spermon JR, De Geus-Oei LF, Kiemeney LA. The role of (18)fluoro-2-deoxyglucose positron emission tomography in initial staging and re-staging after chemotherapy for testicular germ cell tumours. BJU Int 2002;89:549556.

    • Search Google Scholar
    • Export Citation
  • 73.

    De Santis M, Pont J. The role of positron emission tomography in germ cell cancer. World J Urol 2004;22:4146.

  • 74.

    De Santis M, Becherer A, Bokemeyer C. 2-18fluoro-deoxy-D-glucose positron emission tomography is a reliable predictor for viable tumor in postchemotherapy seminoma: an update of the prospective multicentric SEMPET trial. J Clin Oncol 2004;22:10341039.

    • Search Google Scholar
    • Export Citation
  • 75.

    Ehrlich Y, Brames MJ, Beck SD. Long-term follow-up of cisplatin combination chemotherapy in patients with disseminated nonseminomatous germ cell tumors: is a postchemotherapy retroperitoneal lymph node dissection needed after complete remission? J Clin Oncol 2010;28:531536.

    • Search Google Scholar
    • Export Citation
  • 76.

    Kollmannsberger C, Daneshmand S, So A. Management of disseminated nonseminomatous germ cell tumors with risk-based chemotherapy followed by response-guided postchemotherapy surgery. J Clin Oncol 2010;28:537542.

    • Search Google Scholar
    • Export Citation
  • 77.

    Kondagunta GV, Bacik J, Sheinfeld J. Paclitaxel plus Ifosfamide followed by high-dose carboplatin plus etoposide in previously treated germ cell tumors. J Clin Oncol 2007;25:8590.

    • Search Google Scholar
    • Export Citation
  • 78.

    Miller KD, Loehrer PJ, Gonin R, Einhorn LH. Salvage chemotherapy with vinblastine, ifosfamide, and cisplatin in recurrent seminoma. J Clin Oncol 1997;15:14271431.

    • Search Google Scholar
    • Export Citation
  • 79.

    Loehrer PJ Sr., Lauer R, Roth BJ. Salvage therapy in recurrent germ cell cancer: ifosfamide and cisplatin plus either vinblastine or etoposide. Ann Intern Med 1988;109:540546.

    • Search Google Scholar
    • Export Citation
  • 80.

    Kondagunta GV, Bacik J, Donadio A. Combination of paclitaxel, ifosfamide, and cisplatin is an effective second-line therapy for patients with relapsed testicular germ cell tumors. J Clin Oncol 2005;23:65496555.

    • Search Google Scholar
    • Export Citation
  • 81.

    Schmoll HJ, Jordan K, Huddart R. Testicular seminoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2010;21 Suppl 5:v140146.

    • Search Google Scholar
    • Export Citation
  • 82.

    Flechon A, Bompas E, Biron P, Droz JP. Management of post-chemotherapy residual masses in advanced seminoma. J Urol 2002;168:19751979.

  • 83.

    Herr HW, Sheinfeld J, Puc HS. Surgery for a post-chemotherapy residual mass in seminoma. J Urol 1997;157:860862.

  • 84.

    de Wit M, Brenner W, Hartmann M. [18F]-FDG-PET in clinical stage I/II non-seminomatous germ cell tumours: results of the German multicentre trial. Ann Oncol 2008;19:16191623.

    • Search Google Scholar
    • Export Citation
  • 85.

    Huddart RA, O'Doherty MJ, Padhani A. 18fluorodeoxyglucose positron emission tomography in the prediction of relapse in patients with high-risk, clinical stage I nonseminomatous germ cell tumors: preliminary report of MRC Trial TE22—the NCRI Testis Tumour Clinical Study Group. J Clin Oncol 2007;25:30903095.

    • Search Google Scholar
    • Export Citation
  • 86.

    Sheinfeld J, Herr HW. Role of surgery in management of germ cell tumor. Semin Oncol 1998;25:203209.

  • 87.

    Colls BM, Harvey VJ, Skelton L. Late results of surveillance of clinical stage I nonseminoma germ cell testicular tumours: 17 years' experience in a national study in New Zealand. BJU Int 1999;83:7682.

    • Search Google Scholar
    • Export Citation
  • 88.

    Read G, Stenning SP, Cullen MH. Medical Research Council prospective study of surveillance for stage I testicular teratoma. Medical Research Council Testicular Tumors Working Party. J Clin Oncol 1992;10:17621768.

    • Search Google Scholar
    • Export Citation
  • 89.

    Sturgeon JF, Moore MJ, Kakiashvili DM. Non-risk-adapted surveillance in clinical stage I nonseminomatous germ cell tumors: the Princess Margaret Hospital's experience. Eur Urol 2011;59:556562.

    • Search Google Scholar
    • Export Citation
  • 90.

    Zuniga A, Kakiashvili D, Jewett MA. Surveillance in stage I nonseminomatous germ cell tumours of the testis. BJU Int 2009;104:13511356.

  • 91.

    Oliver RT, Ong J, Shamash J. Long-term follow-up of Anglian Germ Cell Cancer Group surveillance versus patients with Stage 1 nonseminoma treated with adjuvant chemotherapy. Urology 2004;63:556561.

    • Search Google Scholar
    • Export Citation
  • 92.

    de Bruin MJ, Oosterhof GO, Debruyne FM. Nerve-sparing retroperitoneal lymphadenectomy for low stage testicular cancer. Br J Urol 1993;71:336339.

    • Search Google Scholar
    • Export Citation
  • 93.

    Stephenson AJ, Bosl GJ, Motzer RJ. Retroperitoneal lymph node dissection for nonseminomatous germ cell testicular cancer: impact of patient selection factors on outcome. J Clin Oncol 2005;23:27812788.

    • Search Google Scholar
    • Export Citation
  • 94.

    Bohlen D, Borner M, Sonntag RW. Long-term results following adjuvant chemotherapy in patients with clinical stage I testicular nonseminomatous malignant germ cell tumors with high risk factors. J Urol 1999;161:11481152.

    • Search Google Scholar
    • Export Citation
  • 95.

    Bohlen D, Burkhard FC, Mills R. Fertility and sexual function following orchiectomy and 2 cycles of chemotherapy for stage I high risk nonseminomatous germ cell cancer. J Urol 2001;165:441444.

    • Search Google Scholar
    • Export Citation
  • 96.

    Chevreau C, Mazerolles C, Soulie M. Long-term efficacy of two cycles of BEP regimen in high-risk stage I nonseminomatous testicular germ cell tumors with embryonal carcinoma and/or vascular invasion. Eur Urol 2004;46:209214.

    • Search Google Scholar
    • Export Citation
  • 97.

    Cullen MH, Stenning SP, Parkinson MC. Short-course adjuvant chemotherapy in high-risk stage I nonseminomatous germ cell tumors of the testis: a Medical Research Council report. J Clin Oncol 1996;14:11061113.

    • Search Google Scholar
    • Export Citation
  • 98.

    Oliver RT, Raja MA, Ong J, Gallagher CJ. Pilot study to evaluate impact of a policy of adjuvant chemotherapy for high risk stage 1 malignant teratoma on overall relapse rate of stage 1 cancer patients. J Urol 1992;148:14531455.

    • Search Google Scholar
    • Export Citation
  • 99.

    Pont J, Albrecht W, Postner G. Adjuvant chemotherapy for high-risk clinical stage I nonseminomatous testicular germ cell cancer: long-term results of a prospective trial. J Clin Oncol 1996;14:441448.

    • Search Google Scholar
    • Export Citation
  • 100.

    Studer UE, Fey MF, Calderoni A. Adjuvant chemotherapy after orchiectomy in high-risk patients with clinical stage I non-seminomatous testicular cancer. Eur Urol 1993;23:444449.

    • Search Google Scholar
    • Export Citation
  • 101.

    Sharir S, Foster RS, Donohue JP, Jewett MA. What is the appropriate follow-up after treatment? Semin Urol Oncol 1996;14:4553.

  • 102.

    Chevreau C, Mazerolles C, Soulie M. Long-term efficacy of two cycles of BEP regimen in high-risk stage I nonseminomatous testicular germ cell tumors with embryonal carcinoma and/or vascular invasion. Eur Urol 2004;46:209214; discussion 214–215.

    • Search Google Scholar
    • Export Citation
  • 103.

    Meinardi MT, Gietema JA, van der Graaf WT. Cardiovascular morbidity in long-term survivors of metastatic testicular cancer. J Clin Oncol 2000;18:17251732.

    • Search Google Scholar
    • Export Citation
  • 104.

    Berger CC, Bokemeyer C, Schneider M. Secondary Raynaud's phenomenon and other late vascular complications following chemotherapy for testicular cancer. Eur J Cancer 1995;31A:22292238.

    • Search Google Scholar
    • Export Citation
  • 105.

    Strumberg D, Brugge S, Korn MW. Evaluation of long-term toxicity in patients after cisplatin-based chemotherapy for non-seminomatous testicular cancer. Ann Oncol 2002;13:229236.

    • Search Google Scholar
    • Export Citation
  • 106.

    Bokemeyer C, Berger CC, Kuczyk MA, Schmoll HJ. Evaluation of long-term toxicity after chemotherapy for testicular cancer. J Clin Oncol 1996;14:29232932.

    • Search Google Scholar
    • Export Citation
  • 107.

    Bajorin DF, Motzer RJ, Rodriguez E. Acute nonlymphocytic leukemia in germ cell tumor patients treated with etoposide-containing chemotherapy. J Natl Cancer Inst 1993;85:6062.

    • Search Google Scholar
    • Export Citation
  • 108.

    Albers P, Siener R, Krege S. Randomized phase III trial comparing retroperitoneal lymph node dissection with one course of bleomycin and etoposide plus cisplatin chemotherapy in the adjuvant treatment of clinical stage I Nonseminomatous testicular germ cell tumors: AUO trial AH 01/94 by the German Testicular Cancer Study Group. J Clin Oncol 2008;26:29662972.

    • Search Google Scholar
    • Export Citation
  • 109.

    Culine S, Theodore C, Terrier-Lacombe MJ, Droz JP. Primary chemotherapy in patients with nonseminomatous germ cell tumors of the testis and biological disease only after orchiectomy. J Urol 1996;155:12961298.

    • Search Google Scholar
    • Export Citation
  • 110.

    Davis BE, Herr HW, Fair WR, Bosl GJ. The management of patients with nonseminomatous germ cell tumors of the testis with serologic disease only after orchiectomy. J Urol 1994;152:111113; discussion 114.

    • Search Google Scholar
    • Export Citation
  • 111.

    Stephenson AJ, Bosl GJ, Motzer RJ. Nonrandomized comparison of primary chemotherapy and retroperitoneal lymph node dissection for clinical stage IIA and IIB nonseminomatous germ cell testicular cancer. J Clin Oncol 2007;25:55975602.

    • Search Google Scholar
    • Export Citation
  • 112.

    Weissbach L, Bussar-Maatz R, Flechtner H. RPLND or primary chemotherapy in clinical stage IIA/B nonseminomatous germ cell tumors? Results of a prospective multicenter trial including quality of life assessment. Eur Urol 2000;37:582594.

    • Search Google Scholar
    • Export Citation
  • 113.

    Donohue JP, Thornhill JA, Foster RS. Clinical stage B non-seminomatous germ cell testis cancer: the Indiana University experience (1965-1989) using routine primary retroperitoneal lymph node dissection. Eur J Cancer 1995;31A:15991604.

    • Search Google Scholar
    • Export Citation
  • 114.

    Pizzocaro G. Retroperitoneal lymph node dissection in clinical stage IIA and IIB nonseminomatous germ cell tumours of the testis. Int J Androl 1987;10:269275.

    • Search Google Scholar
    • Export Citation
  • 115.

    Culine S, Theodore C, Court BH. Evaluation of primary standard cisplatin-based chemotherapy for clinical stage II non-seminomatous germ cell tumours of the testis. Br J Urol 1997;79:258262.

    • Search Google Scholar
    • Export Citation
  • 116.

    Rabbani F, Sheinfeld J, Farivar-Mohseni H. Low-volume nodal metastases detected at retroperitoneal lymphadenectomy for testicular cancer: pattern and prognostic factors for relapse. J Clin Oncol 2001;19:20202025.

    • Search Google Scholar
    • Export Citation
  • 117.

    Stephenson AJ, Bosl GJ, Bajorin DF. Retroperitoneal lymph node dissection in patients with low stage testicular cancer with embryonal carcinoma predominance and/or lymphovascular invasion. J Urol 2005;174:557560; discussion 560.

    • Search Google Scholar
    • Export Citation
  • 118.

    Carver BS, Shayegan B, Eggener S. Incidence of metastatic nonseminomatous germ cell tumor outside the boundaries of a modified postchemotherapy retroperitoneal lymph node dissection. J Clin Oncol 2007;25:43654369.

    • Search Google Scholar
    • Export Citation
  • 119.

    Williams SD, Stablein DM, Einhorn LH. Immediate adjuvant chemotherapy versus observation with treatment at relapse in pathological stage II testicular cancer. N Engl J Med 1987;317:14331438.

    • Search Google Scholar
    • Export Citation
  • 120.

    Sheinfeld J, Motzer RJ, Rabbani F. Incidence and clinical outcome of patients with teratoma in the retroperitoneum following primary retroperitoneal lymph node dissection for clinical stages I and IIA nonseminomatous germ cell tumors. J Urol 2003;170:11591162.

    • Search Google Scholar
    • Export Citation
  • 121.

    Vogelzang NJ, Fraley EE, Lange PH. Stage II nonseminomatous testicular cancer: a 10-year experience. J Clin Oncol 1983;1:171178.

  • 122.

    Behnia M, Foster R, Einhorn LH. Adjuvant bleomycin, etoposide and cisplatin in pathological stage II non-seminomatous testicular cancer. the Indiana University experience. Eur J Cancer 2000;36:472475.

    • Search Google Scholar
    • Export Citation
  • 123.

    Kondagunta GV, Sheinfeld J, Mazumdar M. Relapse-free and overall survival in patients with pathologic stage II nonseminomatous germ cell cancer treated with etoposide and cisplatin adjuvant chemotherapy. J Clin Oncol 2004;22:464467.

    • Search Google Scholar
    • Export Citation
  • 124.

    Motzer RJ, Sheinfeld J, Mazumdar M. Etoposide and cisplatin adjuvant therapy for patients with pathologic stage II germ cell tumors. J Clin Oncol 1995;13:27002704.

    • Search Google Scholar
    • Export Citation
  • 125.

    Donohue JP, Thornhill JA, Foster RS. The role of retroperitoneal lymphadenectomy in clinical stage B testis cancer: the Indiana University experience (1965 to 1989). J Urol 1995;153:8589.

    • Search Google Scholar
    • Export Citation
  • 126.

    Hartlapp JH, Weissbach L, Bussar-Maatz R. Adjuvant chemotherapy in nonseminomatous testicular tumour stage II. Int J Androl 1987;10:277284.

  • 127.

    Horwich A, Norman A, Fisher C. Primary chemotherapy for stage II nonseminomatous germ cell tumors of the testis. J Urol 1994;151:7277.

  • 128.

    Logothetis CJ, Swanson DA, Dexeus F. Primary chemotherapy for clinical stage II nonseminomatous germ cell tumors of the testis: a follow-up of 50 patients. J Clin Oncol 1987;5:906911.

    • Search Google Scholar
    • Export Citation
  • 129.

    Sternberg CN. Role of primary chemotherapy in stage I and low-volume stage II nonseminomatous germ-cell testis tumors. Urol Clin North Am 1993;20:93109.

    • Search Google Scholar
    • Export Citation
  • 130.

    Bosl GJ, Geller NL, Bajorin D. A randomized trial of etoposide + cisplatin versus vinblastine + bleomycin + cisplatin + cyclophosphamide + dactinomycin in patients with good-prognosis germ cell tumors. J Clin Oncol 1988;6:12311238.

    • Search Google Scholar
    • Export Citation
  • 131.

    Williams SD, Birch R, Einhorn LH. Treatment of disseminated germ-cell tumors with cisplatin, bleomycin, and either vinblastine or etoposide. N Engl J Med 1987;316:14351440.

    • Search Google Scholar
    • Export Citation
  • 132.

    Einhorn LH, Williams SD, Loehrer PJ. Evaluation of optimal duration of chemotherapy in favorable-prognosis disseminated germ cell tumors: a Southeastern Cancer Study Group protocol. J Clin Oncol 1989;7:387391.

    • Search Google Scholar
    • Export Citation
  • 133.

    de Wit R, Stoter G, Kaye SB. Importance of bleomycin in combination chemotherapy for good-prognosis testicular nonseminoma: a randomized study of the European Organization for Research and Treatment of Cancer Genitourinary Tract Cancer Cooperative Group. J Clin Oncol 1997;15:18371843.

    • Search Google Scholar
    • Export Citation
  • 134.

    Horwich A, Sleijfer DT, Fossa SD. Randomized trial of bleomycin, etoposide, and cisplatin compared with bleomycin, etoposide, and carboplatin in good-prognosis metastatic nonseminomatous germ cell cancer: a Multiinstitutional Medical Research Council/European Organization for Research and Treatment of Cancer Trial. J Clin Oncol 1997;15:18441852.

    • Search Google Scholar
    • Export Citation
  • 135.

    Jones RH, Vasey PA. Part II: testicular cancer: management of advanced disease. Lancet Oncol 2003;4:738747.

  • 136.

    de Wit R, Stoter G, Sleijfer DT. Four cycles of BEP vs four cycles of VIP in patients with intermediate-prognosis metastatic testicular non-seminoma: a randomized study of the EORTC Genitourinary Tract Cancer Cooperative Group. European Organization for Research and Treatment of Cancer. Br J Cancer 1998;78:828832.

    • Search Google Scholar
    • Export Citation
  • 137.

    Frohlich MW, Small EJ. Stage II nonseminomatous testis cancer: the roles of primary and adjuvant chemotherapy. Urol Clin North Am 1998;25:451459.

    • Search Google Scholar
    • Export Citation
  • 138.

    Nichols CR, Catalano PJ, Crawford ED. Randomized comparison of cisplatin and etoposide and either bleomycin or ifosfamide in treatment of advanced disseminated germ cell tumors: an Eastern Cooperative Oncology Group, Southwest Oncology Group, and Cancer and Leukemia Group B Study. J Clin Oncol 1998;16:12871293.

    • Search Google Scholar
    • Export Citation
  • 139.

    Toner GC, Panicek DM, Heelan RT. Adjunctive surgery after chemotherapy for nonseminomatous germ cell tumors: recommendations for patient selection. J Clin Oncol 1990;8:16831694.

    • Search Google Scholar
    • Export Citation
  • 140.

    Kuczyk M, Machtens S, Stief C, Jonas U. Management of the post-chemotherapy residual mass in patients with advanced stage non-seminomatous germ cell tumors (NSGCT). Int J Cancer 1999;83:852855.

    • Search Google Scholar
    • Export Citation
  • 141.

    Hartmann JT, Schmoll HJ, Kuczyk MA. Postchemotherapy resections of residual masses from metastatic non-seminomatous testicular germ cell tumors. Ann Oncol 1997;8:531538.

    • Search Google Scholar
    • Export Citation
  • 142.

    Motzer RJ, Geller NL, Tan CC. Salvage chemotherapy for patients with germ cell tumors. The Memorial Sloan-Kettering Cancer Center experience (1979-1989). Cancer 1991;67:13051310.

    • Search Google Scholar
    • Export Citation
  • 143.

    Einhorn LH, Williams SD, Chamness A. High-dose chemotherapy and stem-cell rescue for metastatic germ-cell tumors. N Engl J Med 2007;357:340348.

    • Search Google Scholar
    • Export Citation
  • 144.

    Lorch A, Beyer J, Bascoul-Mollevi C. Prognostic factors in patients with metastatic germ cell tumors who experienced treatment failure with cisplatin-based first-line chemotherapy. J Clin Oncol 2010;28:49064911.

    • Search Google Scholar
    • Export Citation
  • 145.

    Loehrer PJ Sr., Gonin R, Nichols CR. Vinblastine plus ifosfamide plus cisplatin as initial salvage therapy in recurrent germ cell tumor. J Clin Oncol 1998;16:25002504.

    • Search Google Scholar
    • Export Citation
  • 146.

    Lorch A, Rick O, Wundisch T. High dose chemotherapy as salvage treatment for unresectable late relapse germ cell tumors. J Urol 2010;184:168173.

    • Search Google Scholar
    • Export Citation
  • 147.

    Lorch A, Neubauer A, Hackenthal M. High-dose chemotherapy (HDCT) as second-salvage treatment in patients with multiple relapsed or refractory germ-cell tumors. Ann Oncol 2010;21:820825.

    • Search Google Scholar
    • Export Citation
  • 148.

    Albers P, Ganz A, Hannig E. Salvage surgery of chemorefractory germ cell tumors with elevated tumor markers. J Urol 2000;164:381384.

  • 149.

    Kisbenedek L, Bodrogi I, Szeldeli P. Results of salvage retroperitoneal lymphadenectomy (RLA) in the treatment of patients with nonseminomatous germ cell tumours remaining marker positive after inductive chemotherapy. Int Urol Nephrol 1995;27:325329.

    • Search Google Scholar
    • Export Citation
  • 150.

    Motzer RJ, Bosl GJ. High-dose chemotherapy for resistant germ cell tumors: recent advances and future directions. J Natl Cancer Inst 1992;84:17031709.

    • Search Google Scholar
    • Export Citation
  • 151.

    Feldman DR, Sheinfeld J, Bajorin DF. TI-CE high-dose chemotherapy for patients with previously treated germ cell tumors: results and prognostic factor analysis. J Clin Oncol 2010;28:17061713.

    • Search Google Scholar
    • Export Citation
  • 152.

    Baniel J, Foster RS, Gonin R. Late relapse of testicular cancer. J Clin Oncol 1995;13:11701176.

  • 153.

    George DW, Foster RS, Hromas RA. Update on late relapse of germ cell tumor: a clinical and molecular analysis. J Clin Oncol 2003;21:113122.

  • 154.

    Lipphardt ME, Albers P. Late relapse of testicular cancer. World J Urol 2004;22:4754.

  • 155.

    Gerl A, Clemm C, Schmeller N. Late relapse of germ cell tumors after cisplatin-based chemotherapy. Ann Oncol 1997;8:4147.

  • 156.

    Eastham JA, Wilson TG, Russell C. Surgical resection in patients with nonseminomatous germ cell tumor who fail to normalize serum tumor markers after chemotherapy. Urology 1994;43:7480.

    • Search Google Scholar
    • Export Citation
  • 157.

    Wood DP Jr., Herr HW, Motzer RJ. Surgical resection of solitary metastases after chemotherapy in patients with nonseminomatous germ cell tumors and elevated serum tumor markers. Cancer 1992;70:23542357.

    • Search Google Scholar
    • Export Citation
  • 158.

    De Giorgi U, Rosti G, Aieta M. Phase II study of oxaliplatin and gemcitabine salvage chemotherapy in patients with cisplatin-refractory nonseminomatous germ cell tumor. Eur Urol 2006;50:1032-1038; discussion 1038–1039.

    • Search Google Scholar
    • Export Citation
  • 159.

    Kollmannsberger C, Beyer J, Liersch R. Combination chemotherapy with gemcitabine plus oxaliplatin in patients with intensively pretreated or refractory germ cell cancer: a study of the German Testicular Cancer Study Group. J Clin Oncol 2004;22:108114.

    • Search Google Scholar
    • Export Citation
  • 160.

    Pectasides D, Pectasides M, Farmakis D. Gemcitabine and oxaliplatin (GEMOX) in patients with cisplatin-refractory germ cell tumors: a phase II study. Ann Oncol 2004;15:493497.

    • Search Google Scholar
    • Export Citation
  • 161.

    Bokemeyer C, Oechsle K, Honecker F. Combination chemotherapy with gemcitabine, oxaliplatin, and paclitaxel in patients with cisplatin-refractory or multiply relapsed germ-cell tumors: a study of the German Testicular Cancer Study Group. Ann Oncol 2008;19:448453.

    • Search Google Scholar
    • Export Citation
  • 162.

    Einhorn LH, Brames MJ, Juliar B, Williams SD. Phase II study of paclitaxel plus gemcitabine salvage chemotherapy for germ cell tumors after progression following high-dose chemotherapy with tandem transplant. J Clin Oncol 2007;25:513516.

    • Search Google Scholar
    • Export Citation
  • 163.

    Mulherin BP, Brames MJ, Einhorn LH. Long-term survival with paclitaxel and gemcitabine for germ cell tumors after progression following high-dose chemotherapy with tandem transplants [abstract]. J Clin Oncol 2011;29:Abstract 4562.

    • Search Google Scholar
    • Export Citation
  • 164.

    Miller JC, Einhorn LH. Phase II study of daily oral etoposide in refractory germ cell tumors. Semin Oncol 1990;17:3639.

  • 165.

    Fossa SD, Bokemeyer C, Gerl A. Treatment outcome of patients with brain metastases from malignant germ cell tumors. Cancer 1999;85:988997.

  • 166.

    Hartmann J, Bamberg M, Albers P. Multidiciplinary treatment and prognosis of patients with central nervous metastases (CNS) from testicular germ cell tumour (GCT) origin [abstract] Proc Ann Soc Clin Oncol 2003;22:400:Abstract 1607.

    • Search Google Scholar
    • Export Citation
  • 167.

    Bokemeyer C, Nowak P, Haupt A. Treatment of brain metastases in patients with testicular cancer. J Clin Oncol 1997;15:14491454.

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