{"entity":{"id":"seminoma","kind":"cancer","name":"Seminoma","aka":["Classic seminoma","Pure seminoma","Germinoma (when in the brain)"],"tldr":"Seminoma is the slower, more radiosensitive half of testicular cancer. After removal of the testicle most men need no further treatment and are simply monitored; those who relapse or present with spread are cured with a short course of chemotherapy.","summary":"Seminoma arises from germ cell neoplasia in situ and presents as a painless testicular mass, with modest rises in hCG and LDH but never AFP, which would mark a non-seminomatous element. After radical inguinal orchidectomy, stage I disease is managed by surveillance in most men, since only about one in six relapse and all are salvageable; a single dose of carboplatin (MRC TE19) or, rarely now, para-aortic radiotherapy are alternatives. Stage II disease with small nodes is treated with radiotherapy or chemotherapy, and bulkier or metastatic disease with three cycles of BEP or four of EP, curing more than 90 percent; residual masses after chemotherapy are assessed with PET rather than removed. Long-term follow-up watches for second cancers and cardiovascular effects of treatment.","asOf":"2026-09-17","wikipedia":"https://en.wikipedia.org/wiki/Seminoma","links":[{"label":"Wikipedia","url":"https://en.wikipedia.org/wiki/Seminoma"}],"tags":["subtype-page"],"related":["non-seminoma"],"cancers":[],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":["paper-igcccg-classification-jco-1997","paper-mrc-te19-carboplatin-seminoma-oliver-lancet-2005","paper-sempet-de-santis-jco-2004"],"journals":[],"dependsOn":[],"notes":[],"group":"genitourinary","burden":"Just over half of testicular germ cell tumours, peaking in men in their thirties; almost every patient is cured, and the effort now goes into giving the least treatment that keeps it that way.","subtypes":["Stage I seminoma (surveillance)","Stage II seminoma (nodal)","Advanced seminoma (IGCCCG good or intermediate risk)","Spermatocytic tumour (older men, almost never metastasises)"],"biomarkers":["hCG (mildly raised in a minority) and LDH","AFP normal by definition","Tumour size and rete testis invasion (relapse risk in stage I)","PET after chemotherapy for residual masses over 3 cm"],"standardOfCare":[{"setting":"Stage I","approach":"Orchidectomy then surveillance; single-dose carboplatin as an alternative; radiotherapy now rarely used because of second cancers.","refs":["carboplatin","active-surveillance"]},{"setting":"Stage II","approach":"Radiotherapy for small-volume nodes or chemotherapy (BEP or EP) for larger nodes; de-escalation trials of carboplatin with radiotherapy ongoing.","refs":["cisplatin","etoposide","bleomycin","imrt-igrt"]},{"setting":"Advanced","approach":"Three cycles of BEP or four of EP for good risk, four cycles of BEP for intermediate risk; PET-directed management of residual masses.","refs":["bleomycin","etoposide","cisplatin","pet"]}],"stateOfArt":["Surveillance has replaced adjuvant radiotherapy as the standard for stage I, sparing most men any treatment beyond surgery.","Cure rates above 95 percent make late toxicity, second cancers and heart disease the main concern.","De-escalation trials aim to cut chemotherapy and radiotherapy doses further in stage II."],"history":[{"year":1977,"title":"Einhorn's cisplatin combination cures metastatic germ cell tumours","refs":["cisplatin"]},{"year":2005,"title":"MRC TE19: single-dose carboplatin equals radiotherapy in stage I","refs":["carboplatin"]},{"year":2011,"title":"Surveillance endorsed as the preferred stage I option in Europe","refs":[]}],"pipeline":["carboplatin","pet"],"openProblems":["Predicting which stage I patients will relapse.","Late effects of platinum and radiotherapy decades on.","Rare relapses more than five years out."],"parent":"testicular"},"route":"/cancers/seminoma/","neighbours":{"cancer":[{"id":"embryonal-carcinoma-testis","kind":"cancer","name":"Embryonal carcinoma of the testis","route":"/cancers/embryonal-carcinoma-testis/"},{"id":"germ-cell-neoplasia-in-situ","kind":"cancer","name":"Germ cell neoplasia in situ (GCNIS)","route":"/cancers/germ-cell-neoplasia-in-situ/"},{"id":"leydig-cell-tumour","kind":"cancer","name":"Leydig cell tumour of the testis","route":"/cancers/leydig-cell-tumour/"},{"id":"mediastinal-germ-cell-tumour","kind":"cancer","name":"Mediastinal germ cell tumour","route":"/cancers/mediastinal-germ-cell-tumour/"},{"id":"non-seminoma","kind":"cancer","name":"Non-seminomatous germ cell tumour","route":"/cancers/non-seminoma/"},{"id":"retroperitoneal-germ-cell-tumour","kind":"cancer","name":"Retroperitoneal germ cell tumour","route":"/cancers/retroperitoneal-germ-cell-tumour/"},{"id":"spermatocytic-tumour","kind":"cancer","name":"Spermatocytic tumour of the testis","route":"/cancers/spermatocytic-tumour/"},{"id":"testicular","kind":"cancer","name":"Testicular germ cell tumours","route":"/cancers/testicular/"}],"paper":[{"id":"paper-igcccg-classification-jco-1997","kind":"paper","name":"International Germ Cell Consensus Classification: a prognostic factor-based staging system for metastatic germ cell cancers","route":"/key-papers/paper-igcccg-classification-jco-1997/"},{"id":"paper-mrc-te19-carboplatin-seminoma-oliver-lancet-2005","kind":"paper","name":"MRC TE19/EORTC 30982: radiotherapy versus single-dose carboplatin as adjuvant treatment for stage I seminoma","route":"/key-papers/paper-mrc-te19-carboplatin-seminoma-oliver-lancet-2005/"},{"id":"paper-sempet-de-santis-jco-2004","kind":"paper","name":"SEMPET: FDG-PET as a predictor of viable tumour in post-chemotherapy seminoma residuals","route":"/key-papers/paper-sempet-de-santis-jco-2004/"}],"drug":[{"id":"bleomycin","kind":"drug","name":"Bleomycin","route":"/drugs/bleomycin/"},{"id":"carboplatin","kind":"drug","name":"Carboplatin","route":"/drugs/carboplatin/"},{"id":"cisplatin","kind":"drug","name":"Cisplatin","route":"/drugs/cisplatin/"},{"id":"etoposide","kind":"drug","name":"Etoposide","route":"/drugs/etoposide/"}],"technology":[{"id":"active-surveillance","kind":"technology","name":"Active surveillance","route":"/technologies/active-surveillance/"},{"id":"germ-cell-tumour-markers","kind":"technology","name":"AFP, hCG and LDH in germ cell tumours (IGCCCG risk groups)","route":"/technologies/germ-cell-tumour-markers/"},{"id":"imrt-igrt","kind":"technology","name":"IMRT / IGRT (modern external beam)","route":"/technologies/imrt-igrt/"},{"id":"pet","kind":"technology","name":"PET (positron emission tomography)","route":"/technologies/pet/"}],"person":[{"id":"maria-de-santis","kind":"person","name":"Maria De Santis","route":"/people/maria-de-santis/"}],"term":[{"id":"second-primary-bowel-after-abdominal-radiotherapy","kind":"term","name":"Bowel cancer after abdominal and pelvic radiotherapy","route":"/terms/second-primary-bowel-after-abdominal-radiotherapy/"},{"id":"rejuv-second-choices-made-at-treatment","kind":"term","name":"Choices made at the time of treatment that change the second cancer risk","route":"/terms/rejuv-second-choices-made-at-treatment/"},{"id":"rejuv-second-what-is-not-a-second-cancer","kind":"term","name":"What is not a second cancer: recurrence, metastasis and field cancerisation","route":"/terms/rejuv-second-what-is-not-a-second-cancer/"}]}}