French AFU Cancer Committee Guidelines - Update 2022-2024: testicular germ cell cancer.

Area of Science:

• Oncology
• Urology

Background:

• Testicular germ cell cancer (TGCT) management requires updated evidence-based recommendations.
• Accurate diagnosis and staging are crucial for effective treatment planning.

Approach:

• Comprehensive literature review (PubMed, post-2020) on TGCT diagnosis, treatment, and follow-up.
• Evaluation of treatment safety and evidence levels.

Key Points:

• Initial work-up involves clinical exam, serum markers (AFP, hCG, LDH), and imaging (ultrasound, TAP CT).
• Stage I seminoma management favors surveillance or adjuvant carboplatin; radiotherapy indications are limited.
• Stage I non-seminomatous germ cell tumors (NSGCT) offer risk-adapted strategies (surveillance or 1 cycle of BEP [Bleomycin Etoposide Cisplatin]).
• Metastatic TGCT treatment is primarily BEP chemotherapy, with cycle number based on IGCCCG risk groups.
• Post-chemotherapy residual mass assessment guides further management (lymph node dissection for NSGCT, 18F-FDG PET for SGCT).

Conclusions:

• Adherence to updated TGCT management guidelines results in high disease-specific survival rates.
• Survival rates are approximately 99% for stage I and over 85% for metastatic TGCT.