Management of Stage I Nonseminomatous Germ Cell Tumors

Evan Kovac; Andrew J Stephenson

doi:10.1016/j.ucl.2015.04.004

Management of Stage I Nonseminomatous Germ Cell Tumors

Urol Clin North Am. 2015 Aug;42(3):299-310. doi: 10.1016/j.ucl.2015.04.004.

Authors

Evan Kovac¹, Andrew J Stephenson²

Affiliations

¹ Glickman Urological & Kidney Institute, Cleveland Clinic, Mail Code Q10-1, 9500 Euclid Avenue, Cleveland Clinic, Cleveland, OH 44195, USA.
² Center for Urologic Oncology, Glickman Urological & Kidney Institute, Cleveland Clinic, Cleveland Clinic Main Campus, Mail Code Q10-1, 9500 Euclid Avenue, Cleveland, OH 44195, USA. Electronic address: stephea2@ccf.org.

PMID: 26216817
DOI: 10.1016/j.ucl.2015.04.004

Abstract

Testis cancer represents the model for a curable malignancy. Although there is consensus about the appropriate management of metastatic (clinical stage [CS] IIC-III) nonseminomatous germ cell tumor (NSGCT) in terms of the chemotherapy regimens, number of cycles, and the surgical resection of postchemotherapy residual masses, there remains controversy regarding the appropriate management of low-stage NSGCT (CSI-IIB). In this article, the benefits and drawbacks of each treatment option are reviewed; an evidence-based approach when confronted with such a patient and how to best select a treatment avenue based on the patient's clinical and pathologic features are also discussed.

Keywords: Chemotherapy; Germ cell and embryonal; Lymph node excision; Neoplasm staging; Neoplasms; Retroperitoneum; Surveillance; Testicular neoplasms.

Publication types

Review

MeSH terms

Chemotherapy, Adjuvant / methods*
Disease Management
Humans
Lymph Node Excision / methods*
Lymphatic Metastasis
Male
Neoplasm Staging
Neoplasms, Germ Cell and Embryonal* / pathology
Neoplasms, Germ Cell and Embryonal* / therapy
Prognosis
Retroperitoneal Space / pathology*
Risk Assessment
Testicular Neoplasms* / pathology
Testicular Neoplasms* / therapy

Supplementary concepts

Nonseminomatous germ cell tumor