{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T13:51:00Z","timestamp":1781877060440,"version":"3.54.5"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T00:00:00Z","timestamp":1768608000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T00:00:00Z","timestamp":1768608000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universitat de Valencia"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Transl Oncol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Testicular cancer achieves very high cure rates, and current management aims to preserve these outcomes while minimizing treatment-related toxicity. This study aims to describe long-term outcomes of a risk-adapted program for clinical stage I (CSI) testicular germ-cell tumors (TGCT) and to evaluate histopathologic predictors of relapse.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Single-center retrospective cohort (1994\u20132023) of CSI TGCT. Endpoints were relapse, progression-free survival (PFS), cancer-specific survival (CSS), and overall survival (OS). Associations were tested using Cox and Fisher\u2019s exact test; model performance was assessed by discrimination with Harrell\u2019s C-index and 5-year calibration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We retrospectively analyzed 277 selected patients with TGCT, of whom 169 (61%) had CSI disease (seminoma\u2009=\u2009104; NSGCT\u2009=\u200965; median age 32\u00a0years). Initial management was surveillance in 52.1% and adjuvant chemotherapy in 46.2% (carboplatin in seminoma, BEP in NSGCT). After a median follow-up of 87\u00a0months, 17 relapses occurred (10.1%). Adjuvant chemotherapy significantly reduced relapse risk (HR 0.20;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.012). Ten-year OS and CSS were 94.4% and 99.3%, respectively. In surveillance-managed seminoma (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200954), rete testis invasion independently predicted relapse (HR 9.54, 95% CI 1.29\u201370.3;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.027), while the Boorman\u2019s classification distinguished intermediate- from low-risk patients (31.8% vs 6.5%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04). In NSGCT under surveillance, relapse occurred in a single patient with lymphovascular invasion (1\/3, 33.3%) and in 4\/31 (12.9%) without; none relapsed after adjuvant BEP.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Risk-adapted management provides excellent long-term survival in CSI TGCT. Selective adjuvant therapy effectively prevents relapse, while histopathologic risk stratification supports individualized, deescalated strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s12094-025-04183-7","type":"journal-article","created":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T16:26:34Z","timestamp":1768667194000},"page":"2731-2738","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk-adapted management in stage I testicular germ-cell tumors: long-term outcomes from a single-center cohort (1994\u20132023)"],"prefix":"10.1007","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-6803-8228","authenticated-orcid":false,"given":"Patricia","family":"Capdevila","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristobal","family":"Carrasco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saturnino","family":"Luj\u00e1n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Ramos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Aparicio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,17]]},"reference":[{"issue":"35","key":"4183_CR1","doi-asserted-by":"publisher","first-page":"4677","DOI":"10.1200\/JCO.2011.36.0503","volume":"29","author":"J Aparicio","year":"2011","unstructured":"Aparicio J, Maroto P, del Muro XG, Guma J, S\u00e1nchez-Mu\u00f1oz A, Margel\u00ed M, et al. 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The study was approved by the Clinical Research Ethics Committee of Hospital Universitari i Polit\u00e8cnic La Fe (approval number 564, March 6, 2024; protocol code: tumgermI).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent was waived due to the retrospective nature of the study and anonymization of patient data.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Not applicable; the manuscript contains no individual person\u2019s data in any form (including images).","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}}]}}