Testicular germ cell tumor is a paradigm for curable cancer. Early recognition and prompt institution of therapy, with referral to a specialized cancer center as needed, enable a favorable outcome in the vast majority of patients. Accurate serum tumor markers assist in diagnosis and are useful in following a patient's response to therapy. An important distinction in treatment as well as in prognosis is whether the tumor is nonseminomatous or seminomatous. The International Germ Cell Cancer Collaborative Group developed a patient-risk classification for the two types of tumor that is based on prognostic factors (ie, pretreatment tumor-markers levels, site of primary tumor, and presence of nonpulmonary visceral metastatis). Treatment is determined according to this risk classification and the stage of disease. Tumor confined to the testis may be curable with orchiectomy alone, whereas disease involving other sites often requires chemotherapy. Even in metastatic and recurrent disease the cure rate is high.
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