Melissa R Kaufman MD PhD Sam S Chang MD

Vanderbilt University, Department of Urologie Surgery, A-1302 Medical Center North, Nashville, TN 37232, USA

Testicular germ-cell carcinoma, although a rare disease accounting for only 1% to 2% of all neoplasms in men, is distinguished by being the most common malignancy afflicting young men under 45 years of age [1,2]. The worldwide incidence of testicular cancer has shown an alarming increase during the past 40 years [3,4], with more than 8000 cases predicted in the United States in 2005 [5]. Fortunately, with this increasing incidence there has been a concomitant decrease in mortality. For low-stage disease, 5-year survival is estimated at greater than 90% [6]. Multimodal treatment strategies have contributed dramatically to this success.

However, the armamentarium used to provide this long-term survival is not without possible significant sequela for this young patient population [7,8]. Herein we review the treatments used for testicular cancer and the complications associated with each modality of therapy (Table 1). The treatment regimen used for any testicular neoplasm depends on histopathology of the specific tumor and is discussed elsewhere. Staging and treatment are based on primary pathology, involvement of regional lymph nodes, and evidence of metastatic disease, as well as levels of serum tumor markers [9]. It is imperative the clinician recognize possible treatment-related morbidity when counseling and monitoring testicular cancer patients.

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