Testicular germ cell tumors represent the most common malignancies in
young males; 70% of patients with seminomas and 50% of those with
nonseminomatous germ cell tumors ( NSGCT) have clinical stage I at
diagnosis. Lymphovascular invasion, embryonal- cell carcinoma component,
absence of yolk sac histology and MIB1 proliferation rate represent
predictors of micrometastatic disease in stage I NSGCT. Therapeutic
options following orchiectomy in patients with stage I NSGCT comprise
nerve- sparing retroperitoneal lymph node dissection, surveillance or
adjuvant cisplatin- based chemotherapy. All available treatment
modalities produce excellent results, with a long- term survival of
almost 100%. Consequently, therapy- induced toxicity is an important
concern in the management of these patients. An individually tailored
approach that takes into account the prognostic factor profile as well
as the patient’s preferences and their ability to comply with each one
of the modalities is the key to the management of stage I testicular
cancer
