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Controversies in the Management of Stage 1 Non-Seminomatous Germ Cell Tumors

  • Testis and Penile Cancer (M Manoharan and J Sheinfeld, Section Editors)
  • Published:
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Abstract

Post-orchiectomy treatment for clinical stage 1 non-seminomatous germ cell tumors (NSGCT) remains highly debated. Cure rates for testicular germ cell tumors exceed 99 % in early stage disease despite the lack of consensus regarding post-orchiectomy treatment. The controversy relates to the challenge of identifying those patients with clinical stage 1 (CS 1) NSGCT who are most likely to benefit from adjuvant therapies. Established post-orchiectomy treatment options for CS 1 NSGCT include observation, adjuvant chemotherapy and retroperitoneal lymph node dissection. Effective salvage therapies allow for cure rates which approach 100 % for each of these options. The data suggest that low-risk CS 1 NSGCT can be treated with surveillance and consideration for all three options is necessary for high-risk patients. The data show that high-risk patients are those whose disease pathology demonstrates lymphovascular invasion. The decision regarding post-orchiectomy treatment should be based on a discussion with the patient and the specific expertise of the treating institution.

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References

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Conflict of Interest

Dr. Sarah Coleman and Dr. Andrew Stephenson reported no potential conflicts of interest relevant to this article.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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  1. Glickman Urological and Kidney Institute, Cleveland Clinic, 9500 Euclid Avenue, Q10-1, Cleveland, OH, 44195-0001, USA

    Sarah Coleman & Andrew Stephenson

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  1. Sarah Coleman
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  2. Andrew Stephenson
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Correspondence to Andrew Stephenson.

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Coleman, S., Stephenson, A. Controversies in the Management of Stage 1 Non-Seminomatous Germ Cell Tumors. Curr Urol Rep 14, 506–510 (2013). https://doi.org/10.1007/s11934-013-0362-5

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  • DOI: https://doi.org/10.1007/s11934-013-0362-5

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