Management of recurrence and follow-up strategies for patients with seminoma and selected high-risk groups

Seminoma is characterized by high sensitivity to both radiation and chemotherapy. Localized recurrences in the retroperitoneum after surveillance for stage I can be treated with radiotherapy; however, multiple or large bulky retroperitoneal recurrences or systemic metastasis require cisplatin-based chemotherapy Salvage chemotherapy for those patients who recur after initial complete response to induction chemotherapy is based on regimens containing ifosfamide and cisplatin. Incomplete response or failure after induction chemotherapy requires high-dose chemotherapy and stem-cell rescue. Patients with seminoma require long-term follow-up because of the possibility of late recurrence and the risk of a contralateral primary tumor.