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Modern Management of Testicular Cancer

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Genitourinary Cancers

Part of the book series: Cancer Treatment and Research ((CTAR,volume 175))

Abstract

Testicular cancer is a rare urological malignancy with high cure rate. The development of highly effective systemic treatment regimens along with advances in surgical treatment of advanced disease has led to continued improvement in outcomes. Patients with testicular cancer who are treated following the treatment guideline mostly achieved high quality of life and long-term survival. However, patients who were identified as having non-guideline directed care were at significantly higher risk of relapse. In this book chapter, we introduce in depth the modern management of testicular cancer, including diagnosis, staging and risk stratification, treatment strategies of seminoma and non-seminoma germ cell tumors, follow-up protocols, and salvage treatment for disease relapse. We also review new studies and updates on medical and surgical management of advanced testicular cancer.

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References

  1. Siegel R, Miller K, Jemal A (2017) Cancer statistics. CA Cancer J Clin 67:7–30

    Article  Google Scholar 

  2. Nichols C, Roth B, Albers P et al (2013) Active surveillance is the preferred approach to clinical stage I testicular cancer. J Clinic Onc 31:3490

    Google Scholar 

  3. Wymer K, Pearce S, Harris K et al (2017) Adherence to national comprehensive cancer network® guidelines for testicular cancer. J Urol 197:684

    PubMed  Google Scholar 

  4. Eble J, Sauter G, Epstein J (2004) World Health Organization classification of tumors, pathology and genetics of tumors of the urinary system and male genital organs. WHO histological classification of testis Tumors. IARC Press, Lyon, France, p 218

    Google Scholar 

  5. Ulbright TBD (2010) Testicular and paratesticular tumors. In: SE M (ed) Diagnostic surgical pathology. Philadelphia: Lippincott Williams and Wilkins, pp 1944–2004

    Google Scholar 

  6. Krag Jacobsen G, Barlebo H, Olsen J, Schultz HP, Starklint H, Søgaard H et al (1984) Testicular germ cell tumours in Denmark 1976–1980. Pathology of 1058 consecutive cases. Acta Radiol Oncol 23(4):239–247. PubMed PMID: 6093440. eng

    Google Scholar 

  7. Hawkins EP, Finegold MJ, Hawkins HK (1986) Nonseminomatous malignant germ cell tumors in children. A review of 89 cases from the pediatric oncology group, 1971–1984. Cancer 58:2579–2584

    CAS  PubMed  Google Scholar 

  8. Talerman A (1980) Endodermal sinus (yolk sac) tumor elements in testicular germ-cell tumors in adults: comparison of prospective and retrospective studies. Cancer 46(5):1213–1217. PubMed PMID: 6163519. eng

    CAS  PubMed  Google Scholar 

  9. Kim I, Young RH, Scully RE (1985) Leydig cell tumors of the testis. A clinicopathological analysis of 40 cases and review of the literature. Am J Surg Pathol 9(3):177–192. PubMed PMID: 3993830. eng

    CAS  PubMed  Google Scholar 

  10. Stief C, Fizazi K, Evans C (2015) Medical treatment of urologic malignancies. International Consultation on Urologic Diseases

    Google Scholar 

  11. Albers P, Albrecht W, Algaba F et al (2011) EAU guidelines on testicular cancer: 2011 update. Eur Urol 60:304

    PubMed  Google Scholar 

  12. Aganovic L, Cassidy F (2012) Imaging of the scrotum. Radiol Clin North Am 50:1145

    PubMed  Google Scholar 

  13. De Zordo T, Stronegger D, Pallwein-Prettner L et al (2013) Nature reviews. Urology 10:135

    PubMed  Google Scholar 

  14. Aigner F, De Zordo T, Pallwein-Prettner L et al (2012) Real-time sonoelastography for the evaluation of testicular lesions. Radiology 263(2):584

    PubMed  Google Scholar 

  15. Huang DY, Sidhu PS (2012) Focal testicular lesions: colour Doppler ultrasound, contrast-enhanced ultrasound and tissue elastography as adjuvants to the diagnosis. Brit J Radiol 85:S41

    PubMed  Google Scholar 

  16. Gilligan TD, Hayes DF, Seidenfeld J, Temin S (2010) ASCO clinical practice guideline on uses of serum tumor markers in adult males with germ cell tumors. J Oncol Pract 6(4):199–202

    PubMed  PubMed Central  Google Scholar 

  17. International Germ Cell Cancer Collaborative Group: International Germ Cell Consensus Classification (1997) A prognostic factor-based staging system for metastatic germ cell cancer. J Clin Oncol 15, 594

    Google Scholar 

  18. Schnall M, Rosen M (2006) Primer on imaging technologies for cancer. J Clin Oncol 24:3225

    CAS  PubMed  Google Scholar 

  19. O’Malley ME, Chung P, Haider M et al (2010) Comparison of low dose with standard dose abdominal/pelvic multidetector CT in patients with stage 1 testicular cancer under surveillance. Eur Radiol 20:1624

    PubMed  Google Scholar 

  20. Chalian H, Tore HG, Horowitz JM et al (2011) Radiographics: a review publication of the radiological society of North America. Inc. 31:2093

    Google Scholar 

  21. Hilton S, Herr HW, Teitcher JB et al (1997) CT detection of retroperitoneal lymph node metastases in patients with clinical stage I testicular nonseminomatous germ cell cancer: assessment of size and distribution criteria. Am J Roentgenol 169:521

    CAS  Google Scholar 

  22. Hudolin T, Kastelan Z, Knezevic N et al (2012) Correlation between retroperitoneal lymph node size and presence of metastases in nonseminomatous germ cell tumors. Int J Surg Path 20:15

    Google Scholar 

  23. Donohue JP, Thornhill JA, Foster RS et al (1995) The role of retroperitoneal lymphadenectomy in clinical stage B testis cancer: the Indiana University experience (1965 to 1989). J Urol 153:85

    CAS  PubMed  Google Scholar 

  24. Stephenson AJ, Bosl GJ, Motzer RJ et al (2005) Retroperitoneal lymph node dissection for nonseminomatous germ cell testicular cancer: impact of patient selection factors on outcome. J Clin Onc 23:2781

    Google Scholar 

  25. Beyer J, Albers P, Altena R et al (2013) Maintaining success, reducing treatment burden, focusing on survivorship: highlights from the third European consensus conference on diagnosis and treatment of germ-cell cancer. Ann Onc 24:878

    CAS  Google Scholar 

  26. See WA, Hoxie L (1993) Chest staging in testis cancer patients: imaging modality selection based upon risk assessment as determined by abdominal computerized tomography scan results. J Urol 150:874

    CAS  PubMed  Google Scholar 

  27. Cagini L, Nicholson AG, Horwich A et al (1998) Thoracic metastasectomy for germ cell tumours: long term survival and prognostic factors. Ann Onc 9:1185

    CAS  Google Scholar 

  28. White PM, Adamson DJ, Howard et al (1999) Imaging of the thorax in the management of germ cell testicular tumours. Clin Radiol 54:207

    CAS  PubMed  Google Scholar 

  29. Motzer RJ, Agarwal N, Beard C et al (2012) Testicular cancer. J Nat Compr Cancer Netw JNCCN 10:502

    CAS  Google Scholar 

  30. De Santis M, Pont J (2004) The role of positron emission tomography in germ cell cancer. World J Urol 22:41

    PubMed  Google Scholar 

  31. Spermon JR, De Geus-Oei LF, Kiemeney LA et al (2002) 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 89:549

    CAS  PubMed  Google Scholar 

  32. Tsatalpas P, Beuthien-Baumann B, Kropp J et al (2002) Diagnostic value of 18F-FDG positron emission tomography for detection and treatment control of malignant germ cell tumors. Urol Int 68:157

    PubMed  Google Scholar 

  33. de Wit M, Brenner W, Hartmann M et al (2008) [18F]-FDG-PET in clinical stage I/II non-seminomatous germ cell tumours: results of the German multicentre trial. Ann Onc 19:1619

    Google Scholar 

  34. Oechsle K, Hartmann M, Brenner W et al (2008) [18F] Fluorodeoxyglucose positron emission tomography in nonseminomatous germ cell tumors after chemotherapy: the German multicenter positron emission tomography study group. J Clin Onc 20(26):5930

    Google Scholar 

  35. Kollmannsberger C, Oechsle K, Dohmen BM et al (2002) Prospective comparison of [18F] fluorodeoxyglucose positron emission tomography with conventional assessment by computed tomography scans and serum tumor markers for the evaluation of residual masses in patients with non-seminomatous germ cell carcinoma. Cancer 94:2353

    PubMed  Google Scholar 

  36. Daneshmand S, Albers P, Fosså SD et al (2012) Contemporary management of postchemotherapy testis cancer. Eur Urol 62:867

    PubMed  Google Scholar 

  37. Bachner M, Loriot Y, Gross-Goupil M et al (2012) 2-18fluoro-deoxy-D- glucose positron emission tomography (FDG-PET) for postchemotherapy seminoma residual lesions: a retrospective validation of the SEMPET trial. Ann Oncol 23:59

    CAS  PubMed  Google Scholar 

  38. De Santis M, Becherer A, Bokemeyer C et al (2004) 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 22:1034

    PubMed  Google Scholar 

  39. Kollmannsberger C, Nichols C, Bamberg M et al (2000) First-line high-dose chemotherapy ± radiation therapy in patients with metastatic germ-cell cancer and brain metastases. Ann Oncol 11:553

    CAS  PubMed  Google Scholar 

  40. Davis PC, Hudgins PA, Peterman SB et al (1991) Diagnosis of cerebral metastases: double-dose delayed CT vs contrast-enhanced MR imaging. Am J Neurorad 12:293

    CAS  Google Scholar 

  41. Olofsson SE, Tandstad T, Jerkeman M et al (2011) Population-based study of treatment guided by tumor marker decline in patients with metastatic nonseminomatous germ cell tumor: a report from the Swedish-Norwegian testicular cancer group. J Clin Oncol 29:2032

    PubMed  Google Scholar 

  42. Culine S, Kerbrat P, Kramar A et al (2007) Refining the optimal chemotherapy regimen for good-risk metastatic nonseminomatous germ-cell tumors: a randomized trial of the Genito-Urinary Group of the French Federation of Cancer Centers (GETUG T93BP). Ann Oncol 18:917

    CAS  PubMed  Google Scholar 

  43. Tandstad T, Smaaland R, Solberg A et al (2011) Management of seminomatous testicular cancer: a binational prospective population-based study from the Swedish Norwegian testicular cancer study group. J Clin Oncol 29:719

    PubMed  Google Scholar 

  44. de Wit R, Skoneczna I, Daugaard G et al (2012) Randomized phase III study comparing paclitaxel-bleomycin, etoposide, and cisplatin (BEP) to standard BEP in intermediate-prognosis germ-cell cancer: intergroup study EORTC 30983. J Clin Oncol 30:792

    PubMed  PubMed Central  Google Scholar 

  45. Fizazi K, Delva R, Caty A et al (2014) A risk-adapted study of cisplatin and etoposide, with or without ifosfamide, in patients with metastatic seminoma: results of the GETUG S99 multicenter prospective study. Eur Urol 65:381

    CAS  PubMed  Google Scholar 

  46. Fizazi K, Pagliaro L, Flechon A et al (2014) A phase III trial of personalized chemotherapy based on serum tumor marker decline in poor-prognosis germ-cell tumors: Results of GETUG 13. Lancet Oncol 15:1442

    CAS  PubMed  Google Scholar 

  47. Albers P, Siener R, Krege S et al (2008) 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 26:2966–2972

    CAS  PubMed  Google Scholar 

  48. Krege S, Beyer J, Souchon R et al (2008) European consensus conference on diagnosis and treatment of germ cell cancer: a report of the second meeting of the European Germ Cell Cancer Consensus group (EGCCCG): part I. Eur Urol 53:478–496

    PubMed  Google Scholar 

  49. National-Comprehensive-Cancer-Network (2012) CCN-Clinical-Practice-Guidelines-in Oncology—Testicular Cancer. http://www.nccn.org/professionals/physician_gls/pdf/testicular.pdf Version 1, 2012

  50. Cullen MH, Stenning SP, Parkinson MC et al (1996) Short-course adjuvant chemotherapy in high-risk stage I nonseminomatous germ cell tumors of the testis: a medical research council report. J Clin Oncol 14:1106–1113

    CAS  PubMed  Google Scholar 

  51. Tandstad T, Dahl O, Cohn-Cedermark G et al (2009) Risk-adapted treatment in clinical stage I nonseminomatous germ cell testicular cancer: the SWENOTECA management program. J Clin Oncol 27:2122–2128

    PubMed  Google Scholar 

  52. Pont J, Albrecht W, Postner G et al (1996) Adjuvant chemotherapy for high-risk clinical stage I nonseminomatous testicular germ cell cancer: long-term results of a prospective trial. J Clin Oncol 14:441–448

    CAS  PubMed  Google Scholar 

  53. Jewett MAS, Lange PH, Raghavan D (1997) Controversies in the treatment of early stage nonseminomatous testicular cancer. In: Raghavan D, Leibel S, Scher H (eds) Principles and practice of genitourinary oncology. Lippincott Raven

    Google Scholar 

  54. Kollmannsberger C, Moore C, Chi KN et al (2010) Non-risk-adapted surveillance for patients with stage I nonseminomatous testicular germ-cell tumors: diminishing treatment-related morbidity while maintaining efficacy. Ann Oncol 21:1296–1301

    CAS  PubMed  Google Scholar 

  55. Sturgeon JF, Moore MJ, Kakiashvili DM et al (2011) Non-risk-adapted surveillance in clinical stage I nonseminomatous germ cell tumors: the Princess Margaret Hospital’s experience. Eur Urol 59:556–562

    PubMed  Google Scholar 

  56. Colls BM, Harvey VJ, Skelton L et al (1999) 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 83:76–82

    CAS  PubMed  Google Scholar 

  57. Roeleveld TA, Horenblas S, Meinhardt W et al (2001) Surveillance can be the standard of care for stage I nonseminomatous testicular tumors and even high risk patients. J Urol 166:2166–2170

    CAS  PubMed  Google Scholar 

  58. Daugaard G, Petersen PM, Rorth M (2003) Surveillance in stage I testicular cancer. Apmis 111:76–83

    PubMed  Google Scholar 

  59. Atsu N, Eskicorapci S, Uner A et al (2003) A novel surveillance protocol for stage I nonseminomatous germ cell testicular tumours. BJU Int 92:32–35

    CAS  PubMed  Google Scholar 

  60. Sweeney CJ, Hermans BP, Heilman DK et al (2000) Results and outcome of retroperitoneal lymph node dissection for clinical stage I embryonal carcinoma–predominant testis cancer. J Clin Oncol 18:358–362

    CAS  PubMed  Google Scholar 

  61. Hermans BP, Sweeney CJ, Foster RS et al (2000) Risk of systemic metastases in clinical stage I nonseminoma germ cell testis tumor managed by retroperitoneal lymph node dissection. J Urol 163:1721–1724

    CAS  PubMed  Google Scholar 

  62. Stephenson AJ, Bosl GJ, Motzer RJ, Bajorin DF, Stasi JP, Sheinfeld J (2007) Nonrandomized comparison of primary chemotherapy and retroperitoneal lymph node dissection for clinical stage IIA and IIB nonseminomatous germ cell testicular cancer. J Clin Oncol 25(35):5597–5602

    PubMed  Google Scholar 

  63. Weissbach L, Bussar-Maatz R, Flechtner H, Pichlmeier U, Hartmann M, Keller L (2000) 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 37(5):582–594

    CAS  PubMed  Google Scholar 

  64. Donohue JP, Thornhill JA, Foster RS, Rowland RG, Bihrle R (1995) 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 31A(10):1599–1604

    CAS  PubMed  Google Scholar 

  65. Pizzocaro G (1987) Retroperitoneal lymph node dissection in clinical stage IIA and IIB nonseminomatous germ cell tumours of the testis. Int J Androl 10(1):269–275

    CAS  PubMed  Google Scholar 

  66. Santrach PJ, Askin FB, Wells RJ, Azizkhan RG, Merten DF (1989) Nodular form of bleomycin related pulmonary injury in patients with osteogenic sarcoma. Cancer 64:806

    CAS  PubMed  Google Scholar 

  67. Holoye PY, Luna MA, MacKay B, Bedrossian CW (1978) Bleomycin hypersensitivity pneumonitis. Ann Intern Med 88(1):47–49

    CAS  PubMed  Google Scholar 

  68. Jules-Elysee K, White DA (1990) Bleomycin-induced pulmonary toxicity. Clin Chest Med 11:1

    CAS  PubMed  Google Scholar 

  69. Simpson AB, Paul J, Graham J et al (1998) Fatal bleomycin pulmonary toxicity in the west of Scotland 1991–95: a review of patients with germ cell tumours. Br J Cancer 78:1061

    CAS  PubMed  PubMed Central  Google Scholar 

  70. O’Sullivan JM, Huddart RA, Norman AR et al (2003) Predicting the risk of bleomycin lung toxicity in patients with germ-cell tumours. Ann Oncol 14:91

    PubMed  Google Scholar 

  71. von Schlippe M, Fowler CJ, Harland SJ (2001) Cisplatin neurotoxicity in the treatment of metastatic germ cell tumour: time course and prognosis. Br J Cancer 85:823

    PubMed Central  Google Scholar 

  72. Pont J, Albrecht W (1997) Fertility after chemotherapy for testicular germ cell cancer. Fertil Steril 68:1

    CAS  PubMed  Google Scholar 

  73. Travis LB, Andersson M, Gospodarowicz M et al (2000) Treatment-associated leukemia following testicular cancer. J Natl Cancer Inst 92:1165

    CAS  PubMed  Google Scholar 

  74. Nichols CR, Breeden ES, Loehrer PJ et al (1993) Secondary leukemia associated with a conventional dose of etoposide: review of serial germ cell tumor protocols. J Natl Cancer Inst 85:36

    CAS  PubMed  Google Scholar 

  75. Feldman DR, Hu J, Dorff TB, Lim K, Patil S, Woo KM, Carousso M et al (2016) Paclitaxel, ifosfamide and cisplatin efficacy for first-line treatment of patients with intermediate- or poor-risk germ cell tumors. J Clin Oncol 34:2478–2483

    CAS  PubMed  PubMed Central  Google Scholar 

  76. Horwich A, Sleijfer DT, Fossa SD et al (1997) 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 15:1844

    CAS  PubMed  Google Scholar 

  77. Bajorin DF, Sarosdy MF, Pfister DG et al (1993) Randomized trial of etoposide and cisplatin versus etoposide and carboplatin in patients with good-risk germ cell tumors: a multiinstitutional study. J Clin Oncol 11:598

    CAS  PubMed  Google Scholar 

  78. Williams SD, Birch R, Einhorn LH, Irwin L, Greco FA, Loehrer PJ (1987) Treatment of disseminated germ-cell tumors with cisplatin, bleomycin, and either vinblastine or etoposide. N Engl J Med 316(23):1435–1440

    CAS  PubMed  Google Scholar 

  79. de Wit R, Stoter G, Sleijfer DT et al (1998) 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 78(6):828–832

    PubMed  PubMed Central  Google Scholar 

  80. Ravi P, Gray KP, O’Donnell EK, Sweeney CJ (2014) A meta-analysis of patient outcomes with subcentimeter disease after chemotherapy for metastatic non-seminomatous germ cell tumor. Ann Oncol 25(2):331–338

    CAS  PubMed  Google Scholar 

  81. Vergouwe Y, Steyerberg EW, Foster RS et al (2007) Predicting retroperitoneal histology in postchemotherapy testicular germ cell cancer: a model update and multicentre validation with more than 1000 patients. Eur Urol 51:424

    PubMed  Google Scholar 

  82. Beck SD, Foster RS, Bihrle R et al (2007) Post chemotherapy RPLND in patients with elevated markers: current concepts and clinical outcome. Urol Clin North Am 34:219

    PubMed  Google Scholar 

  83. Zon RT, Nichols C, Einhorn LH (1998) Management strategies and outcomes of germ cell tumor patients with very high human chorionic gonadotropin levels. J Clin Oncol 16:1294

    CAS  PubMed  Google Scholar 

  84. Tarin T, Carver B, Sheinfeld J (2011) The role of lymphadenectomy for testicular cancer: indications, controversies, and complications. Urol Clin North Am 38:439

    PubMed  Google Scholar 

  85. Daneshmand S, Stephenson AJ, Sheinfeld J, Jewett MA (2011) The management of subcentimeter residual mass in NSGCT: pcRPLND vs. observation. Urol Oncol 29:842

    PubMed  Google Scholar 

  86. Carver BS, Shayegan B, Eggener S et al (2007) Incidence of metastatic nonseminomatous germ cell tumor outside the boundaries of a modified postchemotherapy retroperitoneal lymph node dissection. J Clin Oncol 25:4365

    PubMed  Google Scholar 

  87. Rabbani F, Goldenberg SL, Gleave ME et al (1998) Retroperitoneal lymphadenectomy for post-chemotherapy residual masses: is a modified dissection and resection of residual masses sufficient? Br J Urol 81:295

    CAS  PubMed  Google Scholar 

  88. Heidenreich A, Pfister D, Witthuhn R et al (2009) Postchemotherapy retroperitoneal lymph node dissection in advanced testicular cancer: radical or modified template resection. Eur Urol 55:217

    PubMed  Google Scholar 

  89. Beck SD, Foster RS, Bihrle R et al (2007) Is full bilateral retroperitoneal lymph node dissection always necessary for postchemotherapy residual tumor? Cancer 110:1235

    PubMed  Google Scholar 

  90. Hu B, Daneshmand S (2015) Role of extraretroperitoneal surgery in patients with metastatic germ cell tumors. Urol Clin North Am 42:369

    PubMed  Google Scholar 

  91. Syan-Bhanvadia S, Bazargani ST, Clifford TG et al (2017) Midline extraperitoneal approach to retroperitoneal lymph node dissection in testicular cancer: minimizing surgical morbidity. Eur Urol (Epub ahead of print)

    Google Scholar 

  92. Calestroupat JP, Sanchez-Salas R, Cathelineau X et al (2009) Postche- motherapy laparoscopic retroperitoneal lymph node dissection in nonseminomatous germ-cell tumor. J Endourol 23:645

    PubMed  Google Scholar 

  93. Steiner H, Leonhartsberger N, Stoehr B et al (2013) Postchemotherapy laparoscopic retroperitoneal lymph node dissection for low-volume, stage II, nonseminomatous germ cell tumor: first 100 patients. Eur Urol 63:1013

    PubMed  Google Scholar 

  94. Stepanian S, Patel M, Porter J (2016) Robot-assisted laparoscopic retroperitoneal lymph node dissection for testicular cancer: evolution of the technique. Eur Urol 70:661

    PubMed  Google Scholar 

  95. Pearce SM, Golan S, Gorin MA et al (2017) Safety and early oncologic effectiveness of primary robotic retroperitoneal lymph node dissection for nonseminomatous germ cell testicular cancer. Eur Urol 71(3):476

    PubMed  Google Scholar 

  96. Djaladat H, Nichols C, Daneshmand S (2012) Adjuvant surgery in testicular cancer patients undergoing postchemotherapy retroperitoneal lymph node dissection. Ann Surg Oncol 19:2388

    PubMed  Google Scholar 

  97. Nguyen CT, Stephenson AJ (2011) Role of postchemotherapy retroperitoneal lymph node dissection in advanced germ cell tumors. Hematol Oncol Clin North Am 25:593

    PubMed  Google Scholar 

  98. Lee DJ, Djaladat H, Tadros NN et al (2014) Growing teratoma syndrome: clinical and radiographic characteristics. Int J Urol 21:905

    PubMed  Google Scholar 

  99. Powles TB, Bhardwa J, Shamash J et al (2005) The changing presentation of germ cell tumours of the testis between 1983 and 2002. BJU Int 95:1197–1200

    PubMed  Google Scholar 

  100. Warde P, Gospodarowicz MK, Panzarella T et al (1995) Stage I testicular seminoma: results of adjuvant irradiation and surveillance. J Clin Oncol 13:2255–2262

    CAS  PubMed  Google Scholar 

  101. Chung P, Mayhew LA, Warde P et al (2010) Management of stage I seminomatous testicular cancer: a systematic review. Clin Oncol (R Coll Radiol) 22:6–16

    CAS  Google Scholar 

  102. Kollmannsberger C, Tyldesley S, Moore C et al (2011) Evolution in management of testicular seminoma: population-based outcomes with selective utilization of active therapies. Ann Oncol 22:808–814

    CAS  PubMed  Google Scholar 

  103. Santoni R, Barbera F, Bertoni F et al (2003) Stage I seminoma of the testis: a bi-institutional retrospective analysis of patients treated with radiation therapy only. BJU Int 92:47–52

    CAS  PubMed  Google Scholar 

  104. Jones WG, Fossa SD, Mead GM et al (2005) 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 23:1200–1208

    PubMed  Google Scholar 

  105. Fossa SD, Horwich A, Russell JM et al (1999) 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 17:1146

    CAS  PubMed  Google Scholar 

  106. Travis LB, Curtis RE, Storm H et al (1997) Risk of second malignant neoplasms among long-term survivors of testicular cancer. J Natl Cancer Inst 89:1429–1439

    CAS  PubMed  Google Scholar 

  107. Zagars GK, Ballo MT, Lee AK et al (2004) Mortality after cure of testicular seminoma. J Clin Oncol 22:640–647

    PubMed  Google Scholar 

  108. Horwich A, Fossa SD, Stenning SP et al (2010) Risk of second cancers among a cohort of 2,703 long-term survivors of testicular seminoma treated with radiotherapy. J Clin Oncol 28: 15 s: (suppl; abstr 4538)

    Google Scholar 

  109. van den Belt-Dusebout AW, de Wit R, Gietema JA et al (2007) Treatment-specific risks of second malignancies and cardiovascular disease in 5-year survivors of testicular cancer. J Clin Oncol 25:4370–4378

    PubMed  Google Scholar 

  110. Oliver RT, Mason MD, Mead GM et al (2005) Radiotherapy versus single-dose carboplatin in adjuvant treatment of stage I seminoma: a randomised trial. Lancet 366:293–300

    CAS  PubMed  Google Scholar 

  111. Oliver RT, Mead GM, Rustin GJ et al (2011) 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 29:957–962

    CAS  PubMed  Google Scholar 

  112. Tandstad T, Cavallin-Stahl E, Dahl O, et al (2014) Management of clinical stage I seminomatous testicular cancer: a report from SWENOTECA. J Clin Oncol 32:5 s (suppl; abstr 4508)

    Google Scholar 

  113. Warde P, Specht L, Horwich A et al (2002) Prognostic factors for relapse in stage I seminoma managed by surveillance: a pooled analysis. J Clin Oncol 20:4448–4452

    PubMed  Google Scholar 

  114. van der Maase H, Specht L, Jacobson GK et al (1993) Surveillance following orchiectomy for stage I seminoma of the testis. Eur J Cancer 29:1931–1934

    Google Scholar 

  115. Germa-Lluch JR, Garcia del Muro X, Maroto P et al (2002) Clinical pattern and therapeutic results achieved in 1490 patients with germ-cell tumours of the testis: the experience of the Spanish Germ-Cell Cancer Group (GG). Eur Urol 42:553–562

    CAS  PubMed  Google Scholar 

  116. Chung PW, Gospodarowicz MK, Panzarella T et al (2004) Stage II testicular seminoma: patterns of recurrence and outcome of treatment. Eur Urol 45:754–759; discussion 759–760

    PubMed  Google Scholar 

  117. Chung PW, Sridharan S, Jewett M et al (2013) Contemporary management of stage I and stage II seminoma. Int J Radiat Oncol Biol Phys 87:2s (Suppl; abstr 206)

    Google Scholar 

  118. Garcia-del-Muro X, Maroto P, Guma J, et al (2008) Chemotherapy as an alternative to radiotherapy in the treatment of stage IIA and IIB testicular seminoma: a Spanish Germ

    Google Scholar 

  119. Warszawski N, Schmucking M (1997) Relapses in early-stage testicular seminoma: radiation therapy versus retroperitoneal lymphadenectomy. Scand J Urol Nephrol 31:355–359

    CAS  PubMed  Google Scholar 

  120. Mezvrishvili Z, Managadze L (2006) Retroperitoneal lymph node dissection for high-risk stage I and stage IIA seminoma. Int Urol Nephrol 38:615–619

    PubMed  Google Scholar 

  121. Hu B, Shah S, Shojaei S, Daneshmand S (2015) Retroperitoneal lymph node dissection as first-line treatment of node-positive seminoma. Clin Genitourin Cancer

    Google Scholar 

  122. Lusch G (2017) Winter, Albers. PD53-11 Primary retroperitoneal lymph node dissection (RPLND) in stage II A/B seminoma patients without adjuvant therapy: a phase II trial (PRIMETEST). J Urol 197:e1044–e1045

    Google Scholar 

  123. Heidenreich A, Thuer D, Polyakov S (2008) Postchemotherapy retroperitoneal lymph node dissection in advanced germ cell tumours of the testis. Eur Urol 53:260

    PubMed  Google Scholar 

  124. Pico J-L, Rosti G, Kramar A et al (2005) A randomized trial of high-dose chemotherapy in the salvage treatment of patients failing first-line platinum chemotherapy for advanced germ cell tumors. Ann Oncol 16:1152

    PubMed  Google Scholar 

  125. Lorch A, Kleinhans A, Kramar A et al (2012) Sequential versus single high-dose chemotherapy in patients with relapsed or refractory germ cell tumors: long-term results of a prospective randomized trial. J Clin Oncol 30:800

    CAS  PubMed  Google Scholar 

  126. Lorch A, Bacoul-Mollevi C, Kramar A et al (2011) Conventional-dose versus high-dose chemotherapy as first salvage treatment in male patients with metastatic germ cell tumors: evidence from a large international database. J Clin Oncol 29:2178

    PubMed  Google Scholar 

  127. Miller KD, Loehrer PJ, Gonin R et al (1997) Salvage chemotherapy with vinblastine, ifosfamide, and cisplatin in recurrent seminoma. J Clin Oncol 15:1427

    CAS  PubMed  Google Scholar 

  128. Motzer RJ, Geller NL, Tan CC et al (1991) Salvage chemotherapy for patients with germ cell tumors. The memorial sloan-kettering cancer center experience (1979–89). Cancer 67:1305

    CAS  PubMed  Google Scholar 

  129. Pizzocaro G, Salvioni R, Piva L et al (1992) Modified cisplatin, etoposide (or vinblastine) and ifosfamide salvage therapy for male germ cell tumors. Long-term results. Ann Oncol 3:211

    CAS  PubMed  Google Scholar 

  130. Loehrer P, Johnson D, Elson P et al (1995) Importance of bleomycin in favorable-prognosis disseminated germ cell tumors: an Eastern Cooperative Oncology Group trial. J Clin Oncol 13:470

    PubMed  Google Scholar 

  131. Motzer RJ, Mazumdar M, Bosl GJ et al (1996) High-dose carboplatin, etoposide, and cyclophosphamide for patients with refractory germ cell tumors: treatment results and prognostic factors for survival and toxicity. J Clin Oncol 14:1098

    CAS  PubMed  Google Scholar 

  132. Oldenburg J, Martin JM, Fossa SD (2006) Late relapses of germ cell malignancies: incidence, management, and prognosis. J Clin Oncol 24:5503

    PubMed  Google Scholar 

  133. Lutke Holzik MF, Hoekstra HJ, Mulder NH et al (2003) Non-germ cell malignancy in residual or recurrent mass after chemotherapy for nonseminomatous testicular germ cell tumor. Ann Surg Oncol 10:131

    PubMed  Google Scholar 

  134. Beck SD, Foster RS, Bihrle R et al (2005) Pathologic findings and therapeutic outcome of desperation post-chemotherapy retroperitoneal lymph node dissection in advanced germ cell cancer. Urol Oncol 23:423

    PubMed  Google Scholar 

  135. Daneshmand S (2015) Role of surgical resection for refractory germ cell tumors. Urol Oncol 33:370

    PubMed  Google Scholar 

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Chen, J., Daneshmand, S. (2018). Modern Management of Testicular Cancer. In: Daneshmand, S., Chan, K. (eds) Genitourinary Cancers . Cancer Treatment and Research, vol 175. Springer, Cham. https://doi.org/10.1007/978-3-319-93339-9_13

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