ABSTRACT

Today, 80 % of patients with testicular germ cell cancer, including metastatic stage, can be cured. %50 of patients with nonseminomatous germ cell are seen clinical stage 1. Management of clinical stage 1 nonseminomatous germ cell tumor includes surveillance, primary chemotherapy and retroperitoneal lymph node dissection. Irrespective of risk classification, all treatment modalities have equal survival rates of 99% to 100%.

Actual challenges are to limit morbidity and late sequels of treatments while maintaining their therapeutic efficacy. Following this goal, surveillance, considered as a therapeutic option, is being broadly developed particularly for localised tumours.

Imaging, in particular computed tomography (CT), plays a central part in the surveillance protocols. There is a tendency towards less frequent use of imaging as supported by recent trials in nonseminomatous germ cell tumor but further studies are needed with respect to the assessment of nonseminomatous germ cell tumor and to evaluate the role of magnetic resonance imaging and FDG- positron emission tomography instead of abdominal CT.

Surveillance as a management strategy in low risk stage 1 testicular nonseminomatous germ cell tumor should be applied joint decision with the patient and must be followed actively.