2. METHODS
2.1 Data identification
For the 2026 Testicular Cancer Guidelines, new and relevant evidence has been identified, collated and appraised through a structured assessment of the literature. For the 2026 TC Guidelines, new and relevant evidence has been identified, collated and appraised through a structured assessment of the literature. A broad and comprehensive scoping exercise covering all areas of the TC Guidelines was carried out. Databases searched included Medline, EMBASE and the Cochrane Libraries, covering a time frame between 1 May 2024 and 1 May 2025. A total of 725 unique records were identified, retrieved and screened for relevance. A total of 20 new references were added to the 2026 TC Guidelines. A detailed search strategy is available online: https://uroweb.org/guidelines/testicular-cancer/publications-appendices.
Recommendations within the Guidelines are developed by the Panels to prioritise clinically important care decisions. The strength of each recommendation is determined by the balance between desirable and undesirable consequences of alternative management strategies, the quality of the evidence (including certainty of estimates), and the nature and variability of patient values and preferences. This decision process, which can be reviewed in the strength rating forms that accompany each guidelines recommendation, addresses a number of key elements:
- the overall quality of the evidence that exists for the recommendation [4];
- the magnitude of the effect (individual or combined effects);
- the certainty of the results (precision, consistency, heterogeneity and other statistical or study related factors);
- the balance between desirable and undesirable outcomes; and
- the impact and certainty of patient values and preferences on the intervention.
Strong recommendations typically indicate a high degree of evidence quality and/or a favourable balance of benefit to harm and patient preference. Weak recommendations typically indicate availability of lower
quality evidence and/or equivocal balance between benefit and harm, and uncertainty or variability of patient preference [5].
Additional methodology information and a list of associations endorsing the EAU Guidelines can be found online: https://uroweb.org/eau-guidelines/methodology-policies.
2.2. Review
The 2020 Guidelines document was subjected to peer-review following publication. The next peer-review is scheduled for 2028.
2.3. Future goals
- The development of a TC survivorship plan in collaboration with patient associations;
- Care pathways on diagnostic, treatment CS I and treatment of metastatic disease;
- Collaboration with the patient office and patient representatives to develop a care pathway focusing on what the patient needs to know from diagnosis through to follow-up.