Testicular Cancer

Full Text Guidelines Summary of Changes Scientific Publications & Appendices Pocket Guidelines Archive Panel

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M.P. Laguna (Chair), P. Albers, W. Albrecht, F. Algaba, C. Bokemeyer, J.L. Boormans, G. Cohn-Cedermark, K. Fizazi, H. Gremmels (Patient advocate), A. Horwich, D. Nichol, N. Nicolai, J. Oldenburg
Guidelines Associates: J. Mayor de Castro, Ch. Fankhauser


1.1.Aim and objectives

The aim of these guidelines is to present the current evidence for the diagnosis and treatment of patients with cancer of the testis. Testicular cancer (TC) represents 5% of urological tumours affecting mostly younger males. This document addresses germ-cell tumours (GCTs) and sex cord/gonadal stromal tumours.

It must be emphasised that clinical guidelines present the best evidence available to the experts but following guideline recommendations will not necessarily result in the best outcome. Guidelines can never replace clinical expertise when making treatment decisions for individual patients, but rather help to focus decisions - also taking personal values and preferences/individual circumstances of patients into account. Guidelines are not mandates and do not purport to be a legal standard of care.

1.2.Panel composition

The EAU Guidelines Panel on Testicular Cancer consists of a multidisciplinary group of clinicians including, urologists, oncologists, radiotherapists and a pathologist. Members of this Panel have been selected, based on their expertise, to represent the professionals treating patients suspected of having testis cancer. All experts involved in the production of this document have submitted potential conflict of interest statements which can be viewed on the EAU website: http://www.uroweb.org/guideline/testicular-cancer/.

1.3.Available publications

A quick reference document (Pocket guidelines) is available, in print and as an app for iOS and Android devices. These are abridged versions which may require consultation together with the full text version. Several scientific publications are available, as are a number of translations of all versions of the EAU Testicular Cancer Guidelines. All documents are accessible through the EAU website: http://www.uroweb.org/guideline/testicular-cancer/.

1.4.Publication history and summary of changes

1.4.1.Publication history

The European Association of Urology (EAU) published the first guidelines on Testicular Cancer in 2001. Since 2008, the Testicular Cancer Guidelines contains a separate chapter on testicular stromal tumours. This document presents a limited update of the 2018 publication. Review papers have been published in the society’s scientific journal European Urology, the latest version dating to 2015 [1].

1.4.2.Summary of changes

For the 2019 Testicular Cancer Guidelines, new references have been added throughout the document. Key changes in this publication include:

  • Additional remarks on pathology examination and description have been added to the text for the 2019 print. This relates, in particular, to the definition and morphological description of Rete Testis Invasion and Vascular Invasion;
  • Citations relating to a number of low quality papers (SEER [The Surveillance, Epidemiology and End Results programme of the National Cncer Institute] database on stromal tumours incidence and retrospective biased FDG-PET [fluorodeoxyglucose-positron emission tomography] scan) have been removed from the text. However, a decision has been made to include some small phase II studies in the relevant text section on second relapse since there are few publications addressing this rare clinical scenario;
  • A number of minor semantic modifications have been corrected in the text and the tables for 2019.