Resumen de SEOM clinical guidelines for diagnosis and treatment of testicular seminoma (2010)

Jorge Aparicio Urtasun, Javier Sastre Valera, Josep Ramon Germà Lluch, Dolores Isla Casado

• Testicular cancer represents the most common malignancy in males aged 15�34 years. Nearly 40% of cases correspond to seminomas and three quarters of them are diagnosed with stage I disease. After orchiectomy, clinical staging should include serial tumour marker assays (alphafetoprotein must be negative), abdominal CT scan and chest X-ray films. Patients with stage I disease can be followed-up (active surveillance) or receive adjuvant carboplatin chemotherapy (those with rete testis invasion or non-compliant with follow-up). More advanced disease (stage II and III) and patients with extragonadal seminomas should receive chemotherapy (3�4 courses of BEP) according to IGCCCG risk classification. Residual lesions must be managed by surveillance if they are smaller than 3 cm, while those larger than 3 cm should be evaluated by means of PET. Surgery is only recommended in PET-positive lesions.