Treatment of advanced seminoma: an update

In this update, the recent developments in the treatment of patients with advanced seminoma are reviewed. Also, the approach for patients with residual disease after chemotherapy is described. It is concluded that the combination of etoposide and cisplatin seems to be the standard treatment for patients with advanced seminoma, showing a durable response in about 90% of the patients. Although the combination of etoposide and carboplatin is less effective, newer carboplatin-based combinations seem to have a comparable efficacy. Residual disease after chemotherapy can be safely observed if the diameter is less than 3 cm; however, residuals larger than 3 cm frequently show a vital tumor and surgical evaluation should therefore be considered.