Review © JNCCN—Journal of the National Comprehensive Cancer Network | Volume 13 Number 6 | June 2015 811 Abstract Testicular cancer is the most common cancer in men aged 15 to 40 years in the United States, Canada, and many European countries. Given the excellent prognosis of most men with testicular cancer, updates in care after treatment have become very important. This article provides a review of the available evidence, integrated with expert medical judgment, in the area of testicular cancer follow- up. (J Natl Compr Canc Netw 2015;13:811–822) Given the excellent prognosis of most men with testicular cancer, updates in care after treatment have become very important. After the diagnosis and treat- ment of testicular cancer, the goal of follow-up care is to identify relapse early enough that effective salvage therapy can be given. Over time, as the risk of relapse diminishes, the focus of care changes to identifying and treating the late effects that patients with testicular cancer are known to experience. This article focuses on the follow-up care given in the frst 5 years after the diagnosis and treatment of testicular cancer. Follow-Up for Testicular Cancer Follow-up care for patients with testicular cancer begins immediately after orchiectomy for those with clinical stage I disease, defned as no evidence of cancer beyond the testicle, who choose an active surveillance man- agement strategy. Active surveillance implies careful monitoring of patients, with treatment reserved exclu- sively for those who experience disease relapse. Patients with stage I disease must have no postorchiectomy tumor marker elevation and no evidence of cancer in any lymph node chain or soft tissue. 6 Beyond a good history and physical examination, the standard base- line workup for men with testicular cancer consists of obtaining preorchiectomy tumor markers, specifcally α-fetoprotein (AFP), β-human chorionic gonadotro- pin (β-HCG), and lactate dehydrogenase (LDH), and postorchiectomy markers markers with the exception of patients with clinical stage I seminoma in whom postor- chiectomy markers may not be helpful in the detection of recurrent cancer. 7 An abdominopelvic CT scan is the universally accepted imaging technique for evaluat- ing both lymph nodes and abdominal soft tissues. The lymph nodes most at risk of involvement by testicular From a Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women’s Hospital, Boston, Massachusetts; b Division of Medical Oncology, Mofftt Cancer Center, Tampa, Florida; c Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; d Division of Medical Oncology, Dana-Farber Cancer Institute/Brigham and Women’s Hospital, Boston, Massachusetts; e Department of Hematology/Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania; f Division of Oncology, Stanford University Medical Center, Palo Alto, California; g Division of Hematology/Oncology, The University of California, San Francisco, California; h Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York. Submitted January 28, 2015; accepted for publication May 18, 2015. Dr. Feldman has disclosed that he is a consultant and/or advisory role for Gilead, research support from Bayer, and consultant for Seattle Genetics. The remaining authors have disclosed that they have no fnancial interests, arrangements, affliations, or commercial interests with the manufacturers of any products discussed in this article or their competitors. Portions of this manuscript were published previously in the 2015 Genitourinary Cancers Symposium Daily News. Sweeney C, Beard C. Approaches to Managing Clinical Stage I Testicular Cancer. Available at: http://gucasym.org/approaches-managing-clinical- stage-i-testicular-cancer. Accessed June 8, 2015. Correspondence: Clair J. Beard, MD, Dana-Farber Cancer Institute/ Brigham and Women’s Hospital, 75 Francis Street, ASB-1, Level 2, Boston, MA 02115. E-mail: cbeard@lroc.harvard.edu Follow-Up Management of Patients With Testicular Cancer: A Multidisciplinary Consensus-Based Approach Clair J. Beard, MD a ; Shilpa Gupta, MD b ; Robert J. Motzer, MD c ; Elizabeth K. O’Donnell, MD d ; Elizabeth R. Plimack, MD, MS e ; Kim A. Margolin, MD f ; Charles J. Ryan, MD g ; Joel Sheinfeld, MD h ; and Darren R. Feldman, MD c Testicular cancer is the most common cancer in men aged 15 to 40 years in the United States, Canada, and many European countries. 1,2 The incidence of testicular cancer is increasing in all of these areas, and in several countries it has doubled in the past 20 years. 3 However, available evidence suggests that death from testicular cancer is now rare (<1%–5%) in appropriately managed patients in the United States, Canada, and Europe. 4,5