Recently a rise in the incidence of testicular germ cell cancer (TGCC) has been repeatedly reported in Germany (18% during the period 2000-2006). Future investigations are needed to examine causes for this increase in TGCT. The mortality rates in the western and eastern parts of Germany converge, but there is still a significantly higher mortality rate in the eastern part. Again future investigations are needed to examine causes for this phenomenon. In cases of testicular microlithiasis, testicular biopsies should be considered if further factors representing testicular dysgenesis syndrome are present, such as infertility, atrophic testes, and undescended testes. One course of adjuvant BEP reduces the risk of relapse by approximately 90% and may be a new option as the initial treatment for all CS1 NSGCT. Patients obtaining a CR (<1 cm) after first-line chemotherapy can be safely observed without PC-RPLND. Relapses are rare and potentially curable with further treatment.