Overview
Testicular germ cell tumors are the most common malignancies in adolescent and young men 1. These are curable cancers managed with the intent of cure while minimizing treatment-related side effects 1.
Diagnosis
Inguinal orchiectomy is the primary diagnostic procedure 1.
Patients with persistent markers after orchiectomy or advanced disease at diagnosis should be staged and classified according to the IGCCCG prognostic classification 1.Management
Inguinal orchiectomy is curative for most localized tumors 1.
Adjuvant treatment may be required for patients with unfavorable risk factors for recurrence or those unable to undergo close follow-up 1.
BEP (bleomycin, etoposide, cisplatin) is the most recommended chemotherapy regimen 1.
EP (etoposide, cisplatin) or VIP (etoposide, ifosfamide, cisplatin) may be used to avoid bleomycin in select patients 1.
Efforts should be made to avoid unnecessary delays and dose reductions in chemotherapy 1.
Management of residual masses after chemotherapy differs between seminoma and non-seminoma tumors 1.
Salvage treatment for high-risk, refractory, or relapsed tumors includes conventional-dose chemotherapy (e.g., TIP - paclitaxel, ifosfamide, cisplatin) and/or high-dose chemotherapy, though optimal regimens are not well established 1.
Early complete surgical resection is recommended for late recurrences 1.Special Populations
No information available in the provided abstracts.Key Recommendations
Inguinal orchiectomy is the main diagnostic procedure and is curative for most localized tumors 1. (Evidence: Expert opinion)
BEP chemotherapy is the most recommended regimen for advanced disease or post-orchiectomy adjuvant treatment 1. (Evidence: Expert opinion)
Management of residual masses after chemotherapy should be differentiated based on whether the tumor is a seminoma or non-seminoma 1. (Evidence: Expert opinion)
Patients with high-risk of relapse, refractory tumors, or relapse after chemotherapy should be managed by multidisciplinary teams in experienced centers 1. (Evidence: Expert opinion)References
1 Arranz Arija JA, Del Muro XG, Caro RL, Méndez-Vidal MJ, Pérez-Valderrama B, Aparicio J et al.. SEOM-GG clinical guidelines for the management of germ-cell testicular cancer (2023). Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico 2024. link