[French ccAFU guidelines - update 2020-2022: testicular germ cell tumors]

Area of Science:

• Oncology
• Urology

Background:

• Testicular germ cell cancer requires updated management strategies.
• Current guidelines need refinement based on recent evidence.

Purpose of the Study:

• To update French guidelines for testicular germ cell cancer diagnosis, treatment, and follow-up.
• To incorporate recent evidence on treatment toxicities.

Main Methods:

• Comprehensive Medline search (2018-2020) for testicular germ cell cancer literature.
• Evaluation of evidence levels for diagnosis, treatment, and toxicity.

Main Results:

• Diagnosis relies on physical exam, tumor markers (AFP, hCGt, LDH), and imaging (ultrasound, CT).
• Orchiectomy is first-line; surveillance or carboplatin for stage I seminoma; risk-adapted strategy for non-seminoma.
• PEB chemotherapy for metastatic disease; residual mass management guided by imaging and histology.

Conclusions:

• Accurate staging using classifications is crucial for optimal testicular cancer management.
• Treatment based on established classifications yields high survival rates (99% in CSI, 85% in CSII+).