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Testicular Germ Cell Tumors — Treatment by Stage
Testicular germ
cell tumor
(post-orchiectomy)
Stage I
seminoma
Surveillance
preferred
Single-agent carboplatin
or adjuvant RT
Stage I
non-seminoma
Surveillance
preferred
BEP × 1 (adjuvant)
or nerve-sparing RPLND
Advanced —
IGCCCG good risk
BEP × 3, or EP × 4
bleomycin/etoposide/cisplatin
Advanced —
intermediate / poor risk
BEP × 4
VIP × 4
if bleomycin contraindicated
Relapsed / refractory
TIP salvage chemo
High-dose chemo
+ autologous stem-cell rescue
TI-CE