Testicular Cancer, Version 2.2020, NCCN Clinical Practice Guidelines in Oncology

Area of Science:

• Oncology
• Urology

Background:

• Testicular cancer is uncommon, representing <1% of male tumors, but is the most frequent solid tumor in men aged 20-34.
• Global incidence is rising, with risk factors including family history and cryptorchidism.
• Testicular germ cell tumors (GCTs) are 95% of testicular malignancies, classified as seminoma or nonseminoma.

Purpose of the Study:

• To provide NCCN guideline recommendations for managing adult patients with nonseminomatous GCTs.
• To outline treatment strategies following radical inguinal orchiectomy for nonseminoma.

Main Methods:

• Focuses on NCCN Guidelines for Testicular Cancer.
• Details management based on stage, histology, and risk classification.
• Includes options such as surveillance, systemic therapy, and retroperitoneal lymph node dissection.

Main Results:

• Nonseminoma is more aggressive, yet 5-year survival exceeds 70% with current treatments, even in advanced stages.
• Radical inguinal orchiectomy is the primary treatment.
• Prognosis is poor for patients with brain metastases, with a >50% mortality within 1 year.

Conclusions:

• Effective management strategies exist for nonseminomatous GCTs, improving survival rates.
• Post-orchiectomy care is crucial and individualized.
• Further research may improve outcomes for rare metastatic cases, particularly brain metastases.