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Background <p>In 70–80% of all patients with seminoma, the disease is confined to the testis and classified as stage&#xa0;I. In recent decades, treatment algorithms have been established through clinical trials and possible toxicities examined based on long-term follow-up.</p> Objective <p>This article presents treatment options in consideration of long-term toxicities.</p> Materials and methods <p>Based on a&#xa0;literature review, treatment recommendations and current clinical trials are critically discussed.</p> Results <p>The preferred option in stage&#xa0;I disease is active surveillance. In general, adjuvant carboplatin chemotherapy or radiotherapy can reduce the risk of relapse; however, due to the decreasing toxicity of relapse treatment protocols (Papachritofilou et&#xa0;al. in this issue) and the possibility of less intensive follow-up schedules (TRISST trial), adjuvant treatment is increasingly being de-emphasized. In the future, biomarkers (Zielke et&#xa0;al. in this issue) are expected to better predict the individual relapse risk and may therefore be used to guide treatment decisions.</p> Conclusion <p>Patients with stage&#xa0;I disease and risk factors should be managed with active surveillance. Adjuvant therapy may be cautiously considered in the presence of risk factors.</p>

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Therapie von Keimzelltumoren im Stadium I: Seminom

  • 期刊论文

  • 发表日期：

    2026年2月3日

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  • Arndt-Christian Müller,
  • Julia Heinzelbecker

摘要

Background

In 70–80% of all patients with seminoma, the disease is confined to the testis and classified as stage I. In recent decades, treatment algorithms have been established through clinical trials and possible toxicities examined based on long-term follow-up.

Objective

This article presents treatment options in consideration of long-term toxicities.

Materials and methods

Based on a literature review, treatment recommendations and current clinical trials are critically discussed.

Results

The preferred option in stage I disease is active surveillance. In general, adjuvant carboplatin chemotherapy or radiotherapy can reduce the risk of relapse; however, due to the decreasing toxicity of relapse treatment protocols (Papachritofilou et al. in this issue) and the possibility of less intensive follow-up schedules (TRISST trial), adjuvant treatment is increasingly being de-emphasized. In the future, biomarkers (Zielke et al. in this issue) are expected to better predict the individual relapse risk and may therefore be used to guide treatment decisions.

Conclusion

Patients with stage I disease and risk factors should be managed with active surveillance. Adjuvant therapy may be cautiously considered in the presence of risk factors.