News in Adjuvant Therapy of Non-seminomatous Germ Cell Testicular Tumors of Stage I

Abstract

Thanks to a multidisciplinary approach, testicular germinative tumors are now assigned to a group of highly curable oncologic diseases with favorable prognoses. Despite the gradual increase in the incidence of this type of cancer in recent years, mortality remains low. Yet, guidelines for postoperative treatment of stage I non-seminomatous germ cell testicular tumors remain inconsistent due to the low number of randomized studies. The probability of relapse is strongly associated with the occurrence of lymphangiogenesis. The period after primarily orchiectomy can be utilized for close monitoring, cisplatin-based adjuvant chemotherapy, or retroperitoneal lymphadenectomy. All variants of therapy offer a cure rate of about 99 %. The use of adjuvant chemotherapy, as well as retroperitoneal lymph node dissection, is associated with acute and late adverse effects. The effort to minimize side effects with preserving the lowest number of relapses resulted in the need for comparing the number of chemotherapy cycles and chemotherapy vs. retroperitoneal lymphadenectomy. The aim of this review is to evaluate the different treatment modalities for stage I testicular germ cell tumors with respect to their efficacy and toxicity.