Surveillance programs for stage I nonseminomatous germ cell tumors of the testis

Germ cell tumors of the testes constitute approximately 1-2% of all tumors in males 15-35 years of age. Half of those present as clinical stage I disease. The traditional approach was either a retroperitoneal node dissection or radiotherapy. A historical review of the literature suggested that 70% of these patients were cured and did not benefit from further therapy. This coupled with the advent of tumor markers, advanced diagnostic techniques, and cisplatin based chemotherapy led to the consideration for surveillance programs, thereby offering therapy only to those who required it. This article reviews the surveillance programs described in the literature to date with respect to both suitability and program design.