Staging of testis cancer. Combining serum markers, histologic parameters, and radiographic imaging

Treatment of testis cancer has improved dramatically over the last 25 years with cure rates that now approach 95%. This success in treatment is the result of multimodal therapy that may include cisplatinum-based chemotherapy, surgery, and radiotherapy. Although there is little dispute that chemotherapy is appropriate as initial treatment for advanced testis cancer, controversy remains regarding the management of early stage B and stage A testis cancer. In part, the current controversy is driven by the performance characteristics of presently available staging methods, that may include serum markers, histologic parameters from orchietomy specimens, and radiographic imaging. This article reviews the performance characteristics and use of these staging methods.