Background: Clinical stage I (CSI) testicular germ-cell tumours (TGCT) represent a model of highly curable solid malignancy and the key challenge is now to preserve near-universal cure rates while limiting exposure to potentially toxic adjuvant therapy and long-term sequelae.We evaluated long-term outcomes of a risk-adapted strategy designed to limit chemotherapy to clearly defined high-risk subgroups and to prevent overtreatment in low-risk patients.Methods: Retrospective single-centre cohort of CSI TGCT managed between 1994-2023.Post-orchiectomy management followed a risk-adapted policy.Endpoints were relapse, progression-free survival (PFS), overall survival (OS) and CSS.Associations were analysed with Cox and Fisher's exact tests.In surveillance-managed seminoma, the Boormans three-factor model (categorical size, RTI, LVI) was assessed for discrimination and 5-year calibration.
Gaudens et al. (Sun,) studied this question.