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Diagnosis and Treatment of Early-Stage Testicular Cancer: AUA Guideline Amendment 2023
Andrew Stephenson1, Eric B Bass2, Brooke R Bixler3
1Urologic Oncology, Rush University, Chicago, Illinois.
Purpose:
The purpose of this American Urological Association (AUA) guideline amendment is to provide a useful reference on the effective evidence-based treatment strategies for early-stage testicular cancer.
Methodology/Methods:
The original methodology protocol included searches of PubMed®, Embase®, and the Cochrane Central Register of Controlled Trials (CENTRAL) from January 1980 through August 2018. The search strategy used medical subject heading (MeSH) terms and key words relevant to the diagnosis and treatment of early-stage testicular cancer. The searches conducted for the update presented herein utilized the same methodological protocol to capture literature published through March 2023. When sufficient evidence existed, the body of evidence was assigned a strength rating of A (high), B (moderate), or C (low) for support of Strong, Moderate, or Conditional Recommendations. In the absence of sufficient evidence, additional information is provided as Clinical Principles and Expert Opinions.
Results:
Updates were made to statements on imaging, seminoma management, non-seminoma management, surveillance for stage I testicular cancer, and additional survivorship. Further revisions were made to the methodology and reference sections as appropriate.
Conclusions:
This guideline seeks to improve clinicians' ability to evaluate and treat patients with early-stage testicular cancer based on currently available evidence. Future studies will be essential to further support or refine these statements to improve patient care.
Insights
This updated guideline offers evidence-based treatment strategies for early-stage testicular cancer. It enhances clinical evaluation and management of testicular cancer for improved patient outcomes.
Area of Science:
- Urology
- Oncology
- Evidence-Based Medicine
Background:
- Early-stage testicular cancer requires effective, evidence-based management strategies.
- Clinical practice guidelines are essential for standardizing patient care.
Purpose of the Study:
- To provide an updated reference on effective, evidence-based treatment strategies for early-stage testicular cancer.
- To improve clinicians' ability to evaluate and treat patients with early-stage testicular cancer.
Main Methods:
- Systematic literature searches of PubMed, Embase, and CENTRAL from 1980 to March 2023.
- Evidence strength rated A (high), B (moderate), or C (low) for recommendations.
- Inclusion of Clinical Principles and Expert Opinions where evidence was insufficient.
Main Results:
- Updated statements on imaging, seminoma and non-seminoma management.
- Revised recommendations for surveillance of stage I testicular cancer.
- Inclusion of additional survivorship considerations.
Conclusions:
- The guideline aims to enhance clinical decision-making for early-stage testicular cancer.
- Future research is needed to further refine treatment statements and improve patient care.
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