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[Germ cell tumors of the testes: state of the art].

Germ cell tumors of the testes are rare tumors occurring in young men, the incidence of which increases continuously. They are curable in more than 80% of the cases. The treatment of stage I seminoma is lomboaortic radiotherapy, and that of stage I non-seminomatous tumors is either surveillance, retroperitoneal lymph node dissection or adjuvant chemotherapy according to the risk factors of extra-testicular involvement (pure embryonal carcinoma, vascular invasion). For advanced diseases, the standard treatment is three cycles of bleomycin, etoposide, cisplatin (BEP regimen) or four cycles of the same association without bleomycin (EP regimen) and four cycles of the BEP regimen for patients with good risk and poor risk prognostic characteristics, respectively. The five-year overall survival rates are 90% and 50% for patients with good risk and poor risk factors respectively. It is recommended to resect all residual masses after chemotherapy. The standard salvage treatment is four cycles of vinblastin, ifosfamide, cisplatin (VelP regimen). New associations of drugs are under study in order to improve the overall survival rate for the poor-risk and relapsed-tumors patients.