Follow-up of testicular germ cell cancer patients Interdisciplinary evidence-based recommendations

Clear treatment recommendations for patients with testicular cancer exist and their stringent application has led to significant improvements in remission and survival rates. Moreover, active surveillance has become a cornerstone in the management of clinical stage I seminomatous and nonseminomatous germ cell tumors. On the other hand, the existing recommendations for the follow-up of testis cancer patients differ widely and have been changed frequently in recent years. Follow-up recommendations in this young patient population have to be as evidence-based as possible, feasible in order to ensure adherence, and should not be harmful. Primarily, attention has to be paid to the negative impact of unnecessary radiation exposure. Recently, new evidence has become available regarding the relapse pattern of different disease stages of testicular cancer, the use of imaging at follow-up, and the risks of excessive radiation due to imaging, in particular that of CT scans. An interdisciplinary multinational working group consisting of urologists, medical oncologists, and radiation oncologists has reviewed and discussed the current evidence and on this basis formulated new recommendations for patients with germ cell tumors of the testis.