[Germ cell tumors of the testis]

Testicular cancer is the most common malignancy in men aged 15 to 30 years. In the 1990s testicular cancer has become one of the most curable solid neoplasms, and it can serve as a paradigm for the multimodal treatment of solid malignancies, making even a metastasized cancer a curable disease. The dramatic improvements in survival have occurred as a result of the combination of effective diagnostic techniques, improvement in serum tumour markers, modification of surgical technique and, above all, the development of highly effective multidrug chemotherapeutic regimens based on cisplatin. In the 1990s overall survival for all stages of testicular cancer should be well above 80% and should approach 100% for patients with low stage disease. Important studies forming the basis for the most up to date multimodality treatment are reviewed in this article. Alternative strategies for salvage therapy in poor risk patients and those who failed to respond to treatment are discussed, as well as minimization of toxicity in low risk patients.