Guidelines

Testicular Cancer

9. REFERENCES

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8.Gurney, J.K., et al. International Trends in the Incidence of Testicular Cancer: Lessons from 35 Years and 41 Countries. Eur Urol, 2019. 76: 615. 
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12.Looijenga, L.H.J., et al. Report From the International Society of Urological Pathology (ISUP) Consultation Conference on Molecular Pathology of Urogenital Cancers: IV: Current and Future Utilization of Molecular-Genetic Tests for Testicular Germ Cell Tumors. Am J Surg Pathol, 2020. 44: e66. 
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22.Schaapveld, M., et al. Risk and prognostic significance of metachronous contralateral testicular germ cell tumours. Br J Cancer, 2012. 107: 1637. 
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24.Seikkula, H., et al. Familial aggregation of testicular cancer among early-onset cancer survivors. A prospective observational cohort data from Finland. Cancer Epidemiol, 2020. 69: 101807. 
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25.Maroto, P., et al. Incidence and clinical pattern of contralateral synchronous and metachronous germ cell testicular cancer. Urol Oncol, 2021. 39: 135 e17. 
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26.Blok, J.M., et al. Dose-Dependent Effect of Platinum-Based Chemotherapy on the Risk of Metachronous Contralateral Testicular Cancer. J Clin Oncol, 2021. 39: 319. 
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27.Hellesnes, R., et al. Metachronous Contralateral Testicular Cancer in the Cisplatin Era: A Population-Based Cohort Study. J Clin Oncol, 2021. 39: 308. 
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28.Pluta, J., et al. Identification of 22 susceptibility loci associated with testicular germ cell tumors. Nat Commun, 2021. 12: 4487. 
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29.Moch, H., et al. The 2022 World Health Organization Classification of Tumours of the Urinary System and Male Genital Organs-Part A: Renal, Penile, and Testicular Tumours. Eur Urol, 2022. 82: 458. 
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30.Lobo, J., et al. Expert Genitourinary Pathology Review of Orchiectomy Specimens Should Be Mandatory for Optimal Management. Recommendations from the European Association of Urology Guidelines Panel on Testicular Cancer. Eur Urol, 2025. 
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31.James D. Brierley, et al., The TNM Classification of Malignant Tumours 9th edition. 2025. 
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32.Amin, M.B., et al., AJCC Cancer Staging Manual. 8th ed. AJCC Cancer Staging Manual. 2017. 
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33.Klepp, O., et al. Early clinical stages (CS1, CS1Mk+ and CS2A) of non-seminomatous testis cancer. Value of pre- and post-orchiectomy serum tumor marker information in prediction of retroperitoneal lymph node metastases. Swedish-Norwegian Testicular Cancer Project (SWENOTECA). Ann Oncol, 1990. 1: 281. 
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34.Verhoeven, R.H., et al. Markedly increased incidence and improved survival of testicular cancer in the Netherlands. Acta Oncol, 2014. 53: 342. 
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35.Boormans, J.L., et al. Testicular Tumour Size and Rete Testis Invasion as Prognostic Factors for the Risk of Relapse of Clinical Stage I Seminoma Testis Patients Under Surveillance: a Systematic Review by the Testicular Cancer Guidelines Panel. Eur Urol, 2018. 73: 394. 
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36.Zengerling, F., et al. Prognostic factors for tumor recurrence in patients with clinical stage I seminoma undergoing surveillance-A systematic review. Urol Oncol, 2018. 36: 448. 
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37.Boormans, J.L., et al. Prognostic Factor Risk Groups for Clinical Stage I Seminoma: An Individual Patient Data Analysis by the European Association of Urology Testicular Cancer Guidelines Panel and Guidelines Office. Eur Urol Oncol, 2024. 7: 537. 
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38.Wagner, T., et al. Prognostic Factors for Relapse in Patients With Clinical Stage I Testicular Seminoma: A Nationwide, Population-Based Cohort Study. J Clin Oncol, 2024. 42: 81. 
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39.Wagner, T., et al. Prognostic factors for relapse in patients with clinical stage I testicular non-seminoma: A nationwide, population-based cohort study. Eur J Cancer, 2024. 202: 114025. 
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40.Beyer, J., et al. Survival and New Prognosticators in Metastatic Seminoma: Results From the IGCCCG-Update Consortium. J Clin Oncol, 2021. 39: 1553. 
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41.Germa-Lluch, J.R., et al. Clinical pattern and therapeutic results achieved in 1490 patients with germ-cell tumours of the testis: the experience of the Spanish Germ-Cell Cancer Group (GG). Eur Urol, 2002. 42: 553. 
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42.Angulo, J.C., et al. Clinicopathological study of regressed testicular tumors (apparent extragonadal germ cell neoplasms). J Urol, 2009. 182: 2303. 
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43.Mead, G.M., et al. The International Germ Cell Consensus Classification: a new prognostic factor-based staging classification for metastatic germ cell tumours. Clin Oncol (R Coll Radiol), 1997. 9: 207. 
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44.Gillessen, S., et al. Predicting Outcomes in Men With Metastatic Nonseminomatous Germ Cell Tumors (NSGCT): Results From the IGCCCG Update Consortium. J Clin Oncol, 2021. 39: 1563. 
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45.Ager, M., et al. Radiological features characterising indeterminate testes masses: a systematic review and meta-analysis. BJU Int, 2023. 131: 288. 
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46.Chavarriaga, J., et al. Small Testicular Masses: Contemporary Diagnostic and Treatment Strategies, Future Directions, and Knowledge Gaps. Urol Oncol, 2023. 41: 331. 
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47.Henriques, D., et al. Prevalence and Management of Incidental Testicular Masses-A Systematic Review. J Clin Med, 2022. 11: 5770. 
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48.Tsili, A.C., et al. When to ask for an MRI of the scrotum. Andrology, 2021. 9: 1395. 
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49.de Wit, M., et al. [18F]-FDG-PET in clinical stage I/II non-seminomatous germ cell tumours: results of the German multicentre trial. Ann Oncol, 2008. 19: 1619. 
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50.Huddart, R.A., et al. 18fluorodeoxyglucose positron emission tomography in the prediction of relapse in patients with high-risk, clinical stage I nonseminomatous germ cell tumors: preliminary report of MRC Trial TE22--the NCRI Testis Tumour Clinical Study Group. J Clin Oncol, 2007. 25: 3090. 
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51.Busch, J., et al. Can magnetic resonance imaging replace conventional computerized tomography for follow-up of patients with testicular cancer? A systematic review. World J Urol, 2022. 40: 2843. 
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52.Smith-Bindman, R., et al. Medical Imaging and Pediatric and Adolescent Hematologic Cancer Risk. N Engl J Med, 2025. 393: 1269. 
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53.Pasoglou, V., et al. Whole Body MRI in the Detection of Lymph Node Metastases in Patients with Testicular Germ Cell Cancer. Life (Basel), 2022. 12. 
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54.Feldman, D.R., et al. Brain Metastases in Patients With Germ Cell Tumors: Prognostic Factors and Treatment Options--An Analysis From the Global Germ Cell Cancer Group. J Clin Oncol, 2016. 34: 345. 
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55.Sutcliffe, P., et al. A systematic review of evidence on malignant spinal metastases: natural history and technologies for identifying patients at high risk of vertebral fracture and spinal cord compression. Health Technol Assess, 2013. 17: 1. 
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56.Kaufmann, T.J., et al. Consensus recommendations for a standardized brain tumor imaging protocol for clinical trials in brain metastases. Neuro Oncol, 2020. 22: 757. 
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57.Dieckmann, K.P., et al. Serum Tumour Markers in Testicular Germ Cell Tumours: Frequencies of Elevated Levels and Extents of Marker Elevation Are Significantly Associated with Clinical Parameters and with Response to Treatment. Biomed Res Int, 2019. 2019: 5030349. 
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58.Nicholson, B.D., et al. The diagnostic performance of current tumour markers in surveillance for recurrent testicular cancer: A diagnostic test accuracy systematic review. Cancer Epidemiol, 2019. 59: 15. 
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59.Dieckmann, K.P., et al. Associations of serum levels of microRNA-371a-3p (M371) with risk factors for progression in nonseminomatous testicular germ cell tumours clinical stage 1. World J Urol, 2022. 40: 317. 
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60.Leao, R., et al. Circulating MicroRNAs, the Next-Generation Serum Biomarkers in Testicular Germ Cell Tumours: A Systematic Review. Eur Urol, 2021. 80: 456. 
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61.Belge, G., et al. Serum levels of microRNA-371a-3p are not elevated in testicular tumours of non-germ cell origin. J Cancer Res Clin Oncol, 2021. 147: 435. 
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62.Lafin, J., et al. Refining the serum miR-371a-3p test for viable germ cell tumor detection: identification and definition of an indeterminate range. Res Sq, 2023. 
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63.Patel, H.D., et al. Testis-sparing surgery and scrotal violation for testicular masses suspicious for malignancy: A systematic review and meta-analysis. Urol Oncol, 2020. 38: 344. 
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64.Dieckmann, K.P., et al. Carcinoma in situ of the testis: review of biological and clinical features. Int J Cancer, 1999. 83: 815. 
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65.Nason, G.J., et al. Partial orchiectomy: The Princess Margaret cancer centre experience. Urol Oncol, 2020. 38: 605 e19. 
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66.Fankhauser, C.D., et al. The Role of Frozen Section Examination During Inguinal Exploration in Men with Inconclusive Testicular Tumors: A Systematic Review and Meta-analysis. Eur Urol Focus, 2021. 7: 1400. 
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67.Bieniek, J.M., et al. Prevalence and Management of Incidental Small Testicular Masses Discovered on Ultrasonographic Evaluation of Male Infertility. J Urol, 2018. 199: 481. 
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68.Scandura, G., et al. Incidentally detected testicular lesions <10 mm in diameter: can orchidectomy be avoided? BJU Int, 2018. 121: 575. 
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69.Heidenreich, A., et al. Organ sparing surgery for malignant germ cell tumor of the testis. J Urol, 2001. 166: 2161. 
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70.Paffenholz, P., et al. Testis Sparing Surgery for Benign Testicular Masses: Diagnostics and Therapeutic Approaches. J Urol, 2018. 200: 353. 
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71.Grogg, J.B., et al. Oncological and functional outcomes after testis-sparing surgery in patients with germ cell tumors: a systematic review of 285 cases. World J Urol, 2022. 40: 2293. 
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72.Elert, A., et al. Accuracy of frozen section examination of testicular tumors of uncertain origin. Eur Urol, 2002. 41: 290. 
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73.Skoogh, J., et al. Feelings of loss and uneasiness or shame after removal of a testicle by orchidectomy: a population-based long-term follow-up of testicular cancer survivors. Int J Androl, 2011. 34: 183. 
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74.Robinson, R., et al. Is it safe to insert a testicular prosthesis at the time of radical orchidectomy for testis cancer: an audit of 904 men undergoing radical orchidectomy. BJU Int, 2016. 117: 249. 
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75.Dieckmann, K.P., et al. Prevalence of contralateral testicular intraepithelial neoplasia in patients with testicular germ cell neoplasms. J Clin Oncol, 1996. 14: 3126. 
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76.Ruf, C.G., et al. Contralateral biopsies in patients with testicular germ cell tumours: patterns of care in Germany and recent data regarding prevalence and treatment of testicular intra-epithelial neoplasia. Andrology, 2015. 3: 92. 
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77.Andreassen, K.E., et al. Risk of metachronous contralateral testicular germ cell tumors: a population-based study of 7,102 Norwegian patients (1953-2007). Int J Cancer, 2011. 129: 2867. 
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78.Harland, S.J., et al. Intratubular germ cell neoplasia of the contralateral testis in testicular cancer: defining a high risk group. J Urol, 1998. 160: 1353. 
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79.Tabernero, J., et al. Incidence of contralateral germ cell testicular tumors in South Europe: report of the experience at 2 Spanish university hospitals and review of the literature. J Urol, 2004. 171: 164. 
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80.Albers, P., et al. Clinical course and histopathologic risk factor assessment in patients with bilateral testicular germ cell tumors. Urology, 1999. 54: 714. 
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81.Heidenreich, A., et al. Contralateral testicular biopsy procedure in patients with unilateral testis cancer: is it indicated? Semin Urol Oncol, 2002. 20: 234. 
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82.Giwercman, A., et al. Prevalence of carcinoma in situ and other histopathological abnormalities in testes of men with a history of cryptorchidism. J Urol, 1989. 142: 998. 
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83.Dieckmann, K.P., et al. Diagnosis of contralateral testicular intraepithelial neoplasia (TIN) in patients with testicular germ cell cancer: systematic two-site biopsies are more sensitive than a single random biopsy. Eur Urol, 2007. 51: 175. 
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84.Souchon, R., et al. Contralateral testicular cancer in spite of TIN-negative double biopsies and interval cisplatin chemotherapy. Strahlenther Onkol, 2006. 182: 289. 
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85.Hoei-Hansen, C.E., et al. Carcinoma in situ testis, the progenitor of testicular germ cell tumours: a clinical review. Ann Oncol, 2005. 16: 863. 
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86.Petersen, P.M., et al. Effect of graded testicular doses of radiotherapy in patients treated for carcinoma-in-situ in the testis. J Clin Oncol, 2002. 20: 1537. 
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87.Dieckmann, K.P., et al. Treatment of testicular intraepithelial neoplasia (intratubular germ cell neoplasia unspecified) with local radiotherapy or with platinum-based chemotherapy: a survey of the German Testicular Cancer Study Group. Ann Oncol, 2013. 24: 1332. 
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88.Classen, J., et al. Radiotherapy with 16 Gy may fail to eradicate testicular intraepithelial neoplasia: preliminary communication of a dose-reduction trial of the German Testicular Cancer Study Group. Br J Cancer, 2003. 88: 828. 
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89.Stephenson, A., et al. Diagnosis and Treatment of Early Stage Testicular Cancer: AUA Guideline. J Urol, 2019. 202: 272. 
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90.Christensen, T.B., et al. Effect of chemotherapy on carcinoma in situ of the testis. Ann Oncol, 1998. 9: 657. 
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91.Mortensen, M.S., et al. Treatment options for carcinoma in situ testis. Int J Androl, 2011. 34: e32. 
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92.Moch, H., et al., WHO Classification of Tumours of the Urinary System and Male Genital Organs. 4th ed. 2016, Lyon. 
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93.Verrill, C., et al. Reporting and Staging of Testicular Germ Cell Tumors: The International Society of Urological Pathology (ISUP) Testicular Cancer Consultation Conference Recommendations. Am J Surg Pathol, 2017. 41: e22. 
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94.Verrill, C., et al. Intraoperative Consultation and Macroscopic Handling: The International Society of Urological Pathology (ISUP) Testicular Cancer Consultation Conference Recommendations. Am J Surg Pathol, 2018. 42: e33. 
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95.Berney, D.M., et al. Datasets for the reporting of neoplasia of the testis: recommendations from the International Collaboration on Cancer Reporting. Histopathology, 2019. 74: 171. 
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96.Force, U.S.P.S.T. Screening for testicular cancer: U.S. Preventive Services Task Force reaffirmation recommendation statement. Ann Intern Med, 2011. 154: 483. 
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97.Ilic, D., et al. Screening for testicular cancer. Cochrane Database Syst Rev, 2011: CD007853. 
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98.Chong, R.I.H., et al. Testicular self-examination for early detection of testicular cancer. World J Urol, 2023. 41: 941. 
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99.Groll, R.J., et al. A comprehensive systematic review of testicular germ cell tumor surveillance. Crit Rev Oncol Hematol, 2007. 64: 182. 
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100.Nayan, M., et al. Conditional Risk of Relapse in Surveillance for Clinical Stage I Testicular Cancer. Eur Urol, 2017. 71: 120. 
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101.Tandstad, T., et al. Management of seminomatous testicular cancer: a binational prospective population-based study from the Swedish norwegian testicular cancer study group. J Clin Oncol, 2011. 29: 719. 
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102.Ruf, C.G., et al. Testicular germ cell tumours’ clinical stage I: comparison of surveillance with adjuvant treatment strategies regarding recurrence rates and overall survival-a systematic review. World J Urol, 2022. 40: 2889. 
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103.Chung, P., et al. Management of stage I seminomatous testicular cancer: a systematic review. Clin Oncol (R Coll Radiol), 2010. 22: 6. 
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104.Huang, M.M., et al. Cost-effectiveness Analysis of Non-risk-adapted Active Surveillance for Postorchiectomy Management of Clinical Stage I Seminoma. Eur Urol Focus, 2021. 7: 1409. 
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105.Oliver, R.T., et al. Randomized trial of carboplatin versus radiotherapy for stage I seminoma: mature results on relapse and contralateral testis cancer rates in MRC TE19/EORTC 30982 study (ISRCTN27163214). J Clin Oncol, 2011. 29: 957. 
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106.Aparicio, J., et al. Patterns of relapse and treatment outcome after active surveillance or adjuvant carboplatin for stage I seminoma: a retrospective study of the Spanish Germ Cell Cancer Group. Clin Transl Oncol, 2021. 23: 58. 
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107.Fischer, S., et al. Outcome of Men With Relapse After Adjuvant Carboplatin for Clinical Stage I Seminoma. J Clin Oncol, 2017. 35: 194. 
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108.Powles, T., et al. The long-term risks of adjuvant carboplatin treatment for stage I seminoma of the testis. Ann Oncol, 2008. 19: 443. 
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109.Bieri, S., et al. Seminoma of the testis: is scrotal shielding necessary when radiotherapy is limited to the para-aortic nodes? Radiother Oncol, 1999. 50: 349. 
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110.van den Belt-Dusebout, A.W., et al. Treatment-specific risks of second malignancies and cardiovascular disease in 5-year survivors of testicular cancer. J Clin Oncol, 2007. 25: 4370. 
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111.Horwich, A., et al. Second cancer risk and mortality in men treated with radiotherapy for stage I seminoma. Br J Cancer, 2014. 110: 256. 
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112.Patel, H.D., et al. Radiotherapy for stage I and II testicular seminomas: Secondary malignancies and survival. Urol Oncol, 2017. 35: 606 e1. 
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113.Tandstad, T., et al. Treatment of stage I seminoma, with one course of adjuvant carboplatin or surveillance, risk-adapted recommendations implementing patient autonomy: a report from the Swedish and Norwegian Testicular Cancer Group (SWENOTECA). Ann Oncol, 2016. 27: 1299. 
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114.Chung, P., et al. Evaluation of a prognostic model for risk of relapse in stage I seminoma surveillance. Cancer Med, 2015. 4: 155. 
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115.Mortensen, M.S., et al. A nationwide cohort study of stage I seminoma patients followed on a surveillance program. Eur Urol, 2014. 66: 1172. 
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116.Aparicio, J., et al. Prognostic factors for relapse in stage I seminoma: a new nomogram derived from three consecutive, risk-adapted studies from the Spanish Germ Cell Cancer Group (SGCCG). Ann Oncol, 2014. 25: 2173. 
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117.Kollmannsberger, C., et al. Patterns of relapse in patients with clinical stage I testicular cancer managed with active surveillance. J Clin Oncol, 2015. 33: 51. 
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