Experience demonstrates multiple paths to cure for patients with clinical stage I testicular cancer. Because all options should provide a long-term disease-free rate near 100%, overall survival is no longer relevant in decision making, allowing practitioners to factor in quality of life, toxicity, cost, and impact on compliance. Surveillance for clinical stage I seminoma and clinical stage I nonseminoma has become the preferred option. The contrarian view is that a risk-adapted approach should persist, with surveillance for low-risk individuals and active therapy high-risk individuals. However, results obtained in unselected patients provide a strong argument against the need for such an approach.

The Urologic clinics of North America. 2019 May 16 [Epub]

Bruce J Roth

Division of Oncology/BMT, Department of Medicine, Washington University in St. Louis, 660 South Euclid Avenue, CB 8056, St Louis, MO 63110, USA. Electronic address: .