Albers P., Albrecht W., Algaba F., Bokemeyer C., Cohn-Cedermark G., Fizazi K., Horwich A., Laguna M.P., Nicolai N., Oldenburg J.
European Urology 2015
Context: This is an update of the previous European Association of Urology testis cancer guidelines published in 2011, which included major changes in the diagnosis and treatment of germ cell tumours. Objective: To summarise latest developments in the treatment of this rare disease. Recommendations have been agreed within a multidisciplinary working group consisting of urologists, medical oncologists, and radiation oncologists. Evidence acquisition: A semi-structured literature search up to February 2015 was performed to update the recommendations. In addition, this document was subjected to double-blind peer review before publication. Evidence synthesis: This publication focuses on the most important changes in treatment recommendations for clinical stage I disease and the updated recommendations for follow-up. Conclusions: Most changes in the recommendations will lead to an overall reduction in treatment burden for patients with germ cell tumours. In advanced stages, treatment intensification is clearly defined to further improve overall survival rates. Patient summary: This is an update of a previously published version of the European Association of Urology guidelines for testis cancer, and includes new recommendations for clinical stage I disease and revision of the follow-up recommendations. Patients should be fully informed of all the treatment options available to them. For all stages of testicular cancer, the best cure rates are obtained in high-volume reference centres. Patients diagnosed with testicular cancer should be informed about the short- and long-term side effects of radiotherapy and chemotherapy. The aim of risk-adapted treatment is to reduce long-term treatment-related sequelae without compromising therapeutic efficacy.