(Published 2019; Amended 2023)

Testis cancer is the most common solid malignancy in young males. Testis cancer is a relatively rare malignancy, with outcomes defined by specific cancer- and patient-related factors. The vast majority of men with testis cancer have low-stage disease (limited to the testis and retroperitoneum; clinical stages I-IIB); survival rates are high with standard therapy. A priority for those patients with low-stage disease is limiting the burden of therapy and treatment-related toxicity without compromising cancer control. Thus, surveillance has assumed an increasing role among those with cancer clinically confined to the testis. Likewise, paradigms for management have undergone substantial changes in recent years as evidence regarding risk stratification, recurrence, survival, and treatment-related toxicity has emerged.

Urologists are frequently the initial treating clinician for men with newly diagnosed testis cancer and thus play a crucial role in counseling and treatment decision-making. This clinical practice guideline provides evidence-based recommendations for clinicians regarding the diagnosis, staging, treatment selection, and post-treatment surveillance of patients with clinical stages I, IIA, and IIB seminoma and non-seminomatous germ cell tumor (NSGCT). The clinical guideline includes discussion of the following:

• Diagnosis and initial consultation
• Orchiectomy
• Testis-sparing surgery
• GCNIS Counseling and management
• Staging
• Seminoma and non-seminoma management
• Surveillance and survivorship