Management of testicular seminoma

Testicular seminoma is highly curable with currently available treatments. Today, there is good evidence that patients with Stage I disease can be tre ated equally well with either immediate adjuvant para-aortic and ipsilatera l pelvic radiotherapy or close surveillance with treatment at the time of r elapse. The decision as to which of these management strategies is adopted in an individual case is a complex function of physician preference, and th e emotional, social, and economic circumstances of the patient. Ongoing res earch in Stage I seminoma is focused at reducing the side-effects of treatm ent either by modifying the radiation treatment plan or by using adjuvant c hemotherapy in lieu of radiation. Stage II patients with small bulk retrope ritoneal lymphadenopathy have a high probability of long-term disease contr ol with radiotherapy. Patients with bulky Stage II disease or Stage III dis ease should be treated with cisplatin-based chemotherapy. Semin. Surg. Onco l. 17:240-249, 1999. (C) 1999 Wiley-Liss, Inc.