Advances in the treatment of testicular tumors

Despite impressive advances in the therapy of testis tumors, many controversies remain regarding the optimal therapy for each stage of disease. Primary cytoreductive chemotherapy is the treatment of choice for all advanced germ cell tumors, whether nonseminomatous or seminomatous. The distinction between seminomas and other germ cell tumors may be more historic than real. A unified staging system is desperately needed so that results of treatment modalities may be more easily compared, and the need for further multiinstitutional, randomized treatment protocols is also evident. With present treatment options, about 90% of all patients with germ cell tumors should be cured of their diseases, and aggressive efforts at early recognition and the development of newer therapies for relapsing patients are indicated. While further consideration of the long-term consequences of the various treatment modalities is necessary, any resultant modifications in treatment strategy cannot be at the expense of present cure rates.