UROLOGICAL ONCOLOGY

European consensus conference on diagnosis and treatment of germ cell cancer: a report of the second meeting of the European Germ Cell Cancer Consensus group (EGCCCG): part I
Krege S, Beyer J, Souchon R, Albers P, Albrecht W, Algaba F, et al.
Department of Urology, Krankenhaus Maria-Hilf, Krefeld, Germany
Eur Urol. 2008; 53: 478-96

• Objectives: The first consensus report presented by the European Germ Cell Cancer Consensus Group (EGCCCG) in the year 2004 has found widespread approval by many colleagues throughout the world. In November 2006, the group met a second time under the auspices of the Department of Urology of the Amsterdam Medical Center, Amsterdam, The Netherlands.
• Methods: Medical oncologists, urological surgeons, radiation oncologists as well as pathologists from several European countries reviewed and discussed the data that had emerged since the 2002 conference, and incorporated the new data into updated and revised guidelines. As for the first meeting, the methodology of evidence-based medicine (EBM) was applied. The results of the discussion were compiled by the writing committee. All participants have agreed to this final update.
• Results: The first part of the consensus paper describes the clinical presentation of the primary tumor, its treatment, the importance and treatment of testicular intraepithelial neoplasia (TIN), histological classification, staging and prognostic factors, and treatment of stage I seminoma and non-seminoma.
• Conclusions: Whereas the vast majority of the recommendations made in 2004 remain valid 3 yr later, refinements in the treatment of early- and advanced-stage testicular cancer have emerged from clinical trials. Despite technical improvements, expert clinical skills will continue to be one of the major determinants for the prognosis of patients with germ cell cancer. In addition, the particular needs of testicular cancer survivors have been acknowledged.
  
  
• Editorial Comment
  A large multidisciplinary and international team of oncological specialists from Europe involved in the treatment of testicular tumors met and brought out these two consensus papers on diagnosis, staging and treatment of seminomatous and non-seminomatous testicular cancer.
  The recommendations are based on evidence and on the broad clinical experience of the group and are invaluable for every urologist dealing with testicular cancer. The recommendations are clearly outlined and give detailed help in almost every case, from low-risk tumor with virtually 100% survival to high-risk cancer to almost 50% cure rate if treated appropriately. Again, these consensus papers are highly recommended reading.

Dr. Andreas Bohle
Professor of Urology
HELIOS Agnes Karll Hospital
Bad Schwartau, Germany
E-mail: boehle@urologie-bad-schwartau.de