ADVANCED TESTICULAR CANCER - UPDATE FOR UROLOGISTS

Purpose: Testicular cancer is a model for a curable neoplasm. We revie w past and present accomplishments in treating testis cancer and empha size controversial surgical issues of interest to the urologist. Mater ials and Methods: We reviewed early and recent chemotherapy trials of germ cell tumors, stressing random prospective phase III studies. In a ddition, we address specific and complicated issues that are of partic ular relevance for the urologist, analyzing recently published article s. Results: Cisplatin combination chemotherapy has dramatically improv ed the cure rate for patients with germ cell tumors. The indications f or post-chemotherapy resection for residual masses are discussed. Conc lusions: The major goal 25 years ago was to develop a successful chemo therapy regimen for disseminated disease, which has now been accomplis hed with cisplatin combination chemotherapy. Present issues include op timal treatment in patients with poor prognostic characteristics, salv age chemotherapy strategies and indications for past-chemotherapy surg ical resection.