{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T08:48:36Z","timestamp":1782290916764,"version":"3.54.5"},"reference-count":27,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Andrology"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Testicular cancer (TC) is the most common malignancy in young men and is highly curable with platinum\u2010based chemotherapy. With growing survivorship rates, treatment\u2010related symptom burden and quality of life (QoL) have become increasingly important. This study evaluates the impact of different TC treatments on symptom burden and QoL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods<\/jats:title>\n                    <jats:p>Of 715 patients with TC and primary or postchemotherapy retroperitoneal lymph node dissection (RPLND) treated at the University Hospital D\u00fcsseldorf between 2010 and 2024, 486 eligible survivors were contacted, and 124 (25.5 %) completed a standardized questionnaire. Treatment\u2010related symptoms, including QoL and mental health status, were assessed using the EORTC QLQ\u2010C30 and PHQ\u20109 questionnaires, respectively. Results were compared with age\u2010matched reference values from the general population. A subgroup comparison of clinical stage (CS) II patients treated with primary RPLND versus first\u2010line chemotherapy followed by RPLND was performed to identify chemotherapy\u2010specific effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The median time between last treatment and survey response was 55 months. Twenty\u2010four patients were treated with primary RPLND, 80 patients with adjuvant or first\u2010line chemotherapy and RPLND, and 20 patients with multiple lines of chemotherapy and RPLND. Overall, TC survivors reported high global QoL scores comparable to age\u2010matched normative data. The most frequent treatment\u2010related symptoms were polyneuropathy, tinnitus, retrograde ejaculation, and circulatory disorders, particularly among patients receiving multiple lines of chemotherapy. Subgroup analysis showed that CS II patients treated with a single first\u2010line chemotherapy reported lower social functioning and greater financial distress compared with those managed with surgery alone. Despite the physical impact, depression rates were low and similar to the general population, indicating preserved psychological well\u2010being.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>TC survivors maintain good QoL comparable to the general population despite therapy\u2010related symptoms. While persistent side effects such as polyneuropathy and tinnitus are common, their impact on QoL is limited. However, even first\u2010line chemotherapy affects sexual health, social functioning, and financial well\u2010being, highlighting the importance of the development of new treatment approaches and clinical studies focusing on surgery as a QoL\u2010preserving option in selected low\u2010metastatic cases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/andr.70295","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T08:16:26Z","timestamp":1782288986000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Treatment Intensity on Quality of Life in Patients With Metastatic Testicular Cancer"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-7278-8513","authenticated-orcid":false,"given":"Pailin","family":"Pongratanakul","sequence":"first","affiliation":[{"name":"Department of Urology Medical Faculty and University Hospital of the Heinrich Heine University D\u00fcsseldorf  D\u00fcsseldorf Germany"},{"name":"Centre For Integrated Oncology (CIO) D\u00fcsseldorf CIO Aachen\u2010Bonn\u2010Cologne\u2010D\u00fcsseldorf  D\u00fcsseldorf Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamim","family":"Hadjizada","sequence":"additional","affiliation":[{"name":"Department of Urology Medical Faculty and University Hospital of the Heinrich Heine University D\u00fcsseldorf  D\u00fcsseldorf Germany"},{"name":"Centre For Integrated Oncology (CIO) D\u00fcsseldorf CIO Aachen\u2010Bonn\u2010Cologne\u2010D\u00fcsseldorf  D\u00fcsseldorf Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophia","family":"Thy","sequence":"additional","affiliation":[{"name":"Department of Urology Medical Faculty and University Hospital of the Heinrich Heine University D\u00fcsseldorf  D\u00fcsseldorf Germany"},{"name":"Centre For Integrated Oncology (CIO) D\u00fcsseldorf CIO Aachen\u2010Bonn\u2010Cologne\u2010D\u00fcsseldorf  D\u00fcsseldorf Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marieke","family":"Vermeulen\u2010Spohn","sequence":"additional","affiliation":[{"name":"Department of Urology Medical Faculty and University Hospital of the Heinrich Heine University D\u00fcsseldorf  D\u00fcsseldorf Germany"},{"name":"Centre For Integrated Oncology (CIO) D\u00fcsseldorf CIO Aachen\u2010Bonn\u2010Cologne\u2010D\u00fcsseldorf  D\u00fcsseldorf Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00fcnter","family":"Niegisch","sequence":"additional","affiliation":[{"name":"Department of Urology Medical Faculty and University Hospital of the Heinrich Heine University D\u00fcsseldorf  D\u00fcsseldorf Germany"},{"name":"Centre For Integrated Oncology (CIO) D\u00fcsseldorf CIO Aachen\u2010Bonn\u2010Cologne\u2010D\u00fcsseldorf  D\u00fcsseldorf 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