1. INTRODUCTION
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 post-pubertal testicular germ-cell tumours (TGCTs) in the male including spermatocytic tumour 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 references/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 European Association of Urology (EAU) Guidelines Panel on TC consists of a multidisciplinary group of clinicians including, urologists, medical oncologists, a radiation-oncologist, patient representative and a pathologist. When necessary, consultants from other specialties provide input. Members of this Panel have been selected, based on their expertise, to represent the professionals’ treating patients with TC. All experts involved in the production of this document have submitted potential conflict of interest statements which can be viewed on the EAU website: https://uroweb.org/guidelines/testicular-cancer/panel.
1.3. Available publications
A quick reference document (Pocket guidelines) is available in print. This is an abridged version 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 TC Guidelines. All documents are accessible through the EAU website Uroweb: http://www.uroweb.org/guideline/testicularcancer/. A EAU Guidelines App for iOS and Android devices is also available containing the Pocket Guidelines, interactive algorithms and calculators, clinical decision support tools, guidelines cheat sheets and links to extended guidelines.
1.4. Publication history and summary of changes
1.4.1. Publication history
The EAU published the first guidelines on TC in 2001. Since 2008, the TC Guidelines contains a separate chapter on testicular stromal tumours. The 2024 TC guideline presents a limited update of the 2023 publication. A summary paper of the EAU TC guideline has been published in the society’s scientific journal European Urology in 2023 [1].
1.4.2. Summary of changes
The 2025 edition of the Testicular Cancer Guidelines is a reprint of the 2024 version, with adaptions to the following sections:
- A restructure and rewrite of section 4.3 on Risk factors for relapse in clinical stage I testicular cancer;
- The section on Pathological examination of the testis has been moved to online Appendix 2 – Pathological examination of the testis;
- Restructure and rewrite of section 6.1.2 on Seminoma germ cell tumour clinical stage I