Table 4.

Advantages and disadvantages of different management options in the treatment of stage I seminoma

Management option		Advantage	Disadvantage
Surveillance		- Excellent cancer cure rate - No treatment-related toxicity - Excellent salvage rate - Avoids overtreatment for most patients	- Frequent follow-up CT, with associated long-term risks - Anxiety related to the risk of recurrence
Radiation therapy	Dog-leg	- Excellent cancer cure rate - No need for routine CT - Lower recurrence rates compared with patients managed by surveillance	- Most patients are overtreated - Second malignancy risk - Cardiotoxicity - Fertility impairment
	Para-aortic	- Excellent cancer cure rate - Lower recurrence rate than patients managed by surveillance	- Frequent follow-up CT, with associated long-term risks - Second malignancy risk - Cardiotoxicity - Most patients are overtreated
Chemotherapy		- Excellent cancer cure rate - Lower acute toxicity than radiation therapy	- Long-term survival and toxicity unknown - Frequent follow-up CT, with associated long-term risks - Most patients are overtreated

CT: computerised tomography