Scholarlink

Background <p>Clinical stage&#xa0;I testicular tumors are associated with excellent cure rates. The key clinical question is therefore whether surveillance is sufficient after orchiectomy or whether adjuvant treatment should be used to reduce the relapse risk.</p> Objective <p>This article aims to outline a&#xa0;risk-adapted decision framework for surveillance and adjuvant treatment in stage&#xa0;I seminoma and nonseminoma, with a&#xa0;particular focus on low-risk disease, fertility, and shared decision-making.</p> Materials and methods <p>A&#xa0;narrative review based on current guidelines and selected studies was conducted, addressing relapse risk, survival, toxicity, fertility, and follow-up strategies in stage&#xa0;I testicular tumors.</p> Results <p>In stage&#xa0;I seminoma, surveillance is the standard strategy for most patients, particularly in low-risk disease, provided follow-up is reliable. Under surveillance, the relapse risk is typically about 12–18% overall and often about 4–10% in low-risk constellations. Adjuvant carboplatin may reduce the relapse risk to about 3–9%, but it does not improve the already excellent cancer-specific survival of more than 99% and is only rarely justified in low-risk patients. In stage&#xa0;I nonseminoma, lymphovascular invasion (LVI) is the key clinical risk factor. In the absence of LVI, the relapse risk under surveillance is typically about 10–20%, whereas it is about 40–50% in LVI-positive disease. In patients with a&#xa0;higher relapse risk, adjuvant treatment, usually one cycle of BEP (cisplatin, etoposide, and bleomycin), may reduce the relapse risk to about 2–5%; however, surveillance remains an acceptable option in patients with good compliance.</p> Conclusion <p>The aim is to avoid overtreatment without compromising oncologic safety. Management should be individualized according to histology, risk profile, fertility, toxicity, and the feasibility of follow-up.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Stadium-I-Hodentumoren: Surveillance zuerst, Adjuvanz selektiv

  • 期刊论文

  • 发表日期：

    2026年7月23日

查看全文
  • Yue Che

摘要

Background

Clinical stage I testicular tumors are associated with excellent cure rates. The key clinical question is therefore whether surveillance is sufficient after orchiectomy or whether adjuvant treatment should be used to reduce the relapse risk.

Objective

This article aims to outline a risk-adapted decision framework for surveillance and adjuvant treatment in stage I seminoma and nonseminoma, with a particular focus on low-risk disease, fertility, and shared decision-making.

Materials and methods

A narrative review based on current guidelines and selected studies was conducted, addressing relapse risk, survival, toxicity, fertility, and follow-up strategies in stage I testicular tumors.

Results

In stage I seminoma, surveillance is the standard strategy for most patients, particularly in low-risk disease, provided follow-up is reliable. Under surveillance, the relapse risk is typically about 12–18% overall and often about 4–10% in low-risk constellations. Adjuvant carboplatin may reduce the relapse risk to about 3–9%, but it does not improve the already excellent cancer-specific survival of more than 99% and is only rarely justified in low-risk patients. In stage I nonseminoma, lymphovascular invasion (LVI) is the key clinical risk factor. In the absence of LVI, the relapse risk under surveillance is typically about 10–20%, whereas it is about 40–50% in LVI-positive disease. In patients with a higher relapse risk, adjuvant treatment, usually one cycle of BEP (cisplatin, etoposide, and bleomycin), may reduce the relapse risk to about 2–5%; however, surveillance remains an acceptable option in patients with good compliance.

Conclusion

The aim is to avoid overtreatment without compromising oncologic safety. Management should be individualized according to histology, risk profile, fertility, toxicity, and the feasibility of follow-up.