Abstract
Surveillance is the most frequently used treatment option in testicular germ cell tumour (TGCT) patients in nonmetastasised clinical stageI (cSI). Presentation of indications for surveillance, the process of individual patient's advice and the limitations of surveillance. An overview of the current literature is given, including basic research, systemic reviews and expert recommendations. Basic principles are illustrated by case reports. The risk of progression for cSI TGCT patients under surveillance is 5-30% for seminomas and 15-50% for nonseminomas. Surveillance is the preferred treatment option in seminoma and low-risk nonseminoma without lymphovascular invasion. Patients should be informed concerning the individual risk of progression, the possibilities of adjuvant therapy, side effects of adjuvant therapy, the kind of therapy in case of progression and the cure rate. Ahigh risk of progression, psychological issues and malcompliance are important limitations of surveillance. By thoroughly considering the limitations of surveillance, cSI TGCT patients can be safely treated with surveillance.
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