Stage I testicular germ cell tumors [Les tumeurs germinales du testicule de stade I]

摘要

State I testicular germ cell tumors are actually the most frequent ones, with a cure rate approaching 99%, whatever the histology or the chosen treatment. After orchidectomy it is defined by a normal thoraco-abdomino-pelvic CT scan and a normalized tumor marker, which depends on the initial level and the half-life. The PET CT has no place in the treatment. In the non-seminoma germ cell tumors, the presence of lymphovascular emboli defines a group with a high relapse rate, where an adjuvant chemotherapy with 2 courses of BEP is advised. Patients without emboli are preferably watched. A staging retroperitoneal node dissection has a marginal place. Regarding seminoma, no clear stratification factor is available. Lombo-aortic radiotherapy has been replaced by surveillance as standard treatment, while one single course of carboplatin (AUC 7) is an option. The strict implementation of the follow-up guidelines is mandatory to achieve the expected cure rate.