World Journal of Urology

, Volume 27, Issue 4, pp 455–461 | Cite as

High-risk clinical stage I nonseminomatous germ cell tumors: the case for chemotherapy

Topic Paper


Testis cancer is the most frequent solid malignancy in young men. The majority of patients present with clinical stage I disease and about 50% of them are nonseminomatous germ cell tumors. In this initial stage of disease there is a subgroup of patients at high risk with a likelihood of more than 50% for relapse. Treatment options for these patients include: retroperitoneal lymph node dissection (RPLND), albeit 6–10% of patients will relapse outside the field of RPLND, active surveillance with even higher relapse rates and adjuvant chemotherapy. As most of these patients have the chance to become long-term survivors, avoidance of long-term side effects is of utmost importance. This review provides information on the potential of chemotherapy to achieve a higher chance of cure for patients with high-risk clinical stage I disease than its therapeutic alternatives and addresses toxicity and dose dependency.


Nonseminomatous Germ cell Chemotherapy High risk Testicular neoplasm 


Conflict of interest statement

There is no conflict of interest.


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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  1. 1.Department of UrologyStaedtisches Klinikum KarlsruheKarlsruheGermany
  2. 2.Department of UrologyUniversity Hospital of BernBernSwitzerland

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