Preface

Joel Sheinfeld, MD Guest Editor

Each year there are approximately 8000 new cases of testicular cancer diagnosed in the United States, resulting in almost 400 deaths. The incidence of testicular cancer, the most common solid tumor in men between the ages of 20 and 35 years, is increasing in the United States and Europe. The management of patients who have testicular cancer has evolved significantly over the past 25 years, representing a model in the successful mul-tidisciplinary approach to a solid malignancy with the appropriate integration of surgery and cis-platin-based chemotherapy resulting in improvements in survival from 60% to 65% in the 1960s to greater than 95% at present. Given the high probability of achieving cure, considerable effort has been focused on individualizing therapy for specific patients in an attempt to minimize morbidity and preserve quality of life without adversely impacting survival. This has been possible because of refinements in histologic, sero-logic, and radiographic parameters that have resulted in improved risk assessment for patients of all stages. Surgical techniques and the development of less toxic and more effective chemotherapy regimens have also played a critical role. The apparent overtreatment of many patients and the availability of multiple approaches that achieve cure have resulted in several significant controversies in the management of testicular cancer. The long-term survival of patients has identified significant issues that appear to have been underappreciated in the past, such as late relapse, reoperative surgery, and the long-term sequelae of treatment, particularly chemotherapy. Some of these problems have prompted us to re-examine and challenge previously accepted treatment paradigms. This issue of the Urologic Clinics of North America describes the current state-of-the-art therapy for testicular cancer and specifically addresses some of the important controversies faced by clinicians today. This has been possible because of the insight and expertise of an exceptional group of distinguished urologists, medical and radiation oncologists, and pathologists.

Joel Sheinfeld, MD

Department of Urology Sidney Kimmel Center for Prostate and Urologic Cancers Memorial Sloan-Kettering Cancer Center 353 East 68th Street New York, NY 10021, USA

E-mail address: [email protected]

Urol Clin N Am 34 (2007) 109-117

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