Testicular germ cell tumours. New insights in epidemiology, genetic susceptibility and outcome.

The management of patients with testicular germ cell tumours has changed substantially since the late 1970s, largely because of the ability of cisplatin-based polychemotherapy to cure patients with metastatic disease and also due to the development of new strategies in tumour-reductive surgery and radiotherapy. Today more than 90 percent of patients with newly diagnosed testicular germ cell tumours (seminoma or nonseminoma) are cured with available treatment modalities. Further progress in the management of testicular germ cell tumours could result from an improved understanding of the epidemiology, biology and genetics of this uncommon malignancy.

The present thesis describes several epidemiological aspects of testicular germ cell tumjours and focuses on the role of a genetic susceptibility of this malignant tumour. In addition, the thesis addresses some relevant topics in the current management of patients with stage I as well as metastatic nonseminomatous testicular germ cell tumours (NSTGCT) and reviews the long-term outcome of patients with metastatic NSTGCT treated at the Groningen University Hospital (GUH) in the past two decades.

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