Table 1.

Therapeutic burden associated with the different treatment strategies considering the relapse rates given in the most recent series with risk – adapted management calculated per 100 patients.

Treatment				Therapy at relapse			RPLND/pt	CHT/ pt	Interventions/pt
Surveillance		Pathological stage	Relapse	IGCCCG	CHT	Total number of cycles
	Low risk		14%	12 good 2 intermediate	12 × 3 2 × 4	44	0.04	0.44	0.48
	High risk		53%	45 good 8 intermediate	45 × 3 8 × 4	167	0.14	1.67	1.81
nsRPLND	Low risk	PSI = 72% PSII = 28%	8%	8 good	8 × 3	24	1.0	0.24	1.24
	High risk	PSI = 67% PSII = 33%*	3% 3%	3 good 3 good	3 × 3 8 × 2 2 × 3	31	1.0	0.31	1.31
Primary CHT	High riska		1.5%	2 good	100 × 2 2 × 3	206	0.01	2.06	2.07
	High riskb		3.2%	3 good	100 × 1 3 × 3	109	0.02	1.09	1.11

^*25/33 patients are pN1 with no need for adjuvant chemotherapy, 8/33 patients are pN2 with the need for two cycles of adjuvant chemotherapy.

^aStandard approach with two cycles of cisplatin (Platinol), etoposide and bleomycin (PEB).

^bMinimized approach with one cycle of PEB.

Active surveillance has the lowest therapeutic burden for low-risk patients; active surveillance and primary chemotherapy according to the standard have the highest therapeutic burden for high-risk patients.

RPLND, retroperitoneal lymph node dissection; pt, patient; CHT, chemotherapy; nsRPLND, nerve-sparing RPLND; IGCCCG, .