Intended for healthcare professionals

Clinical Review State of the Art Review

Advances in diagnosis and treatment of testicular cancer

BMJ 2022; 379 doi: (Published 28 November 2022) Cite this as: BMJ 2022;379:e070499
  1. Michal Chovanec, associate professor1,
  2. Liang Cheng, professor2
  1. 12nd Department of Oncology, Faculty of Medicine, Comenius University, National Cancer Institute, Bratislava, Slovakia
  2. 2Department of Pathology and Laboratory Medicine, Warren Alpert Medical School of Brown University, Lifespan Academic Medical Center, Providence, RI, USA
  1. Correspondence to M Chovanec michal.chovanec1{at}


Testicular cancer is a curable cancer. The success of physicians in curing the disease is underpinned by multidisciplinary advances. Cisplatin-based combination chemotherapy and the refinement of post-chemotherapy surgical procedures and diagnostic strategies have greatly improved long term survival in most patients. Despite such excellent outcomes, several controversial dilemmas exist in the approaches to clinical stage I disease, salvage chemotherapy, post-chemotherapy surgical procedures, and implementing innovative imaging studies. Relapse after salvage chemotherapy has a poor prognosis and the optimal treatment is not apparent. Recent research has provided insight into the molecular mechanisms underlying cisplatin resistance. Phase 2 studies with targeted agents have failed to show adequate efficacy; however, our understanding of cisplatin resistant disease is rapidly expanding. This review summarizes recent advances and discusses relevant issues in the biology and management of testicular cancer.


  • Series explanation: State of the Art Reviews are commissioned on the basis of their relevance to academics and specialists in the US and internationally. For this reason they are written predominantly by US authors

  • Contributors: MC and LC contributed equally to the manuscript idea, literature search, and review article writing. LC is the guarantor.

  • Competing interests: We have read and understood the BMJ policy on declaration of interests and declare the following interests: none.

  • Funding: Slovak Research and Development Agency under contract no. APVV-15-0086 and APVV-19-0411 and VEGA 1/0327/19 for MC.

  • Patient involvement: no patients were involved.

  • Provenance and peer review: Commissioned; externally peer reviewed.

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