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Overview of the treatment of testicular germ cell tumors

William K Oh, MD
Section Editor
Philip W Kantoff, MD
Deputy Editor
Michael E Ross, MD


Testicular cancers are one of the most curable solid neoplasms. The five-year survival rate is over 95 percent, and fewer than 400 deaths from testicular cancer are seen in the United States per year [1,2]. Initial therapy of early-stage testicular germ cell tumors (GCTs) is based upon histology and tumor extent (table 1).

An overview of therapy for men with testicular GCTs will be presented here. The clinical manifestations, diagnosis, and staging are presented separately. (See "Clinical manifestations, diagnosis, and staging of testicular germ cell tumors".)


The diagnosis of a testicular malignancy is generally established at radical orchiectomy, which also serves as the initial treatment. Subsequent therapy depends upon histology (seminoma versus nonseminomatous germ cell tumors [GCTs]) and the presence or absence of more extensive disease or other risk factors (algorithm 1 and algorithm 2).

For men who present with clinically advanced disease, we prefer to perform a radical orchiectomy prior to chemotherapy whenever possible. Despite this usual approach, there are some men who present with life-threatening advanced disease who undergo systemic chemotherapy prior to orchiectomy ("delayed orchiectomy"). In such patients, the diagnosis is obtained by biopsy of a metastatic lesion. (See "Radical inguinal orchiectomy for testicular germ cell tumors".)

The final pathologic information is used to stratify treatment by histology. There are two forms of testicular GCTs: nonseminomatous GCTs (NSGCTs) and seminomas. They differ by their clinical and biologic behavior.


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Literature review current through: Sep 2016. | This topic last updated: Apr 4, 2016.
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  1. Ries LA, Eisner MP, Kosary CL, et al. SEER Cancer Statistics Review, 1975-2001, National Cancer Institute, Bethesda, MD, 2004 http://seer.cancer.gov/csr/1975_2007/index.html (Accessed on April 11, 2011).
  2. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016. CA Cancer J Clin 2016; 66:7.