High risk NSGCT: case for surveillance

Introduction Active surveillance, primary retroperitoneal lymph node dissection and adjuvant chemotherapy are treatment options for high-risk clinical stage (CS) I nonseminomatous germ cell testicular tumors (NSGCT). Since 1981, at Princess Margaret Hospital, Toronto, initial active surveillance with treatment delayed until relapse has been the preferred management option for all CS I NSGCT, regardless of baseline risk of relapse which has allowed us to better define and assess the natural history of high-risk tumors.