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 II
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: 497-513

• Objectives: The first consensus report that had been presented by the European Germ Cell Cancer Consensus Group (EGCCCG) in 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, The Netherlands.
• Methods: Medical oncologists, urologic 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 second part of the consensus paper includes the treatment of metastasised disease, residual tumour resection, salvage therapy, follow-up, and late toxicities.
• Conclusions: Whereas the vast majority of the recommendations made in 2004 remain valid 3 yr later, refinements in the treatment of early-stage as well as of 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