Treatment of early (I, IIA/B) stages of germinomas of the testis

Abstract

Germinomas of the testis are most commonly presented in early (I-II) stages. In Stage T, choice of adjuvant therapy is based on the type of a tumor, the presence of risk factors, and a patient’s wishes. Seminoma requires monitoring, radiotherapy (20 Gy paraaortically) or chemotherapy (a course pf carboplatin therapy), non-seminomic testicular tumors call for monitoring, nerve-preserving retroperitoneal lymphadenectomy (NPRLAE) or chemotherapy (2 courses of ВЕР). All treatment modalities ensure recovery in above 95% of patients. In Stage II, the similar results can be achieved by radiotherapy or chemotherapy (3 courses of ВЕР) in patients with seminoma, by NPRLAE or chemotherapy (3 courses of ВЕР) in patients with non-seminomic tumors of the testis. The equal efficiency of all approaches generates a need for discussing all possible treatment modalities with the patient, by taking into account toxicity and convenience.