Monitoring
In general, a highly structured follow-up plan is required, because recurrent disease can be effectively treated and potentially eradicated with salvage therapy. There is no global consensus regarding follow-up protocols, and guideline recommendations and institutional follow-up protocols differ.[113] Follow-up evaluation consists of physical examinations, assessment of tumour markers (lactate dehydrogenase, beta-human chorionic gonadotrophin, and alpha-fetoprotein), and imaging with chest x-ray or chest CT, and abdominal/pelvic CT or MRI scans.[49] The exact frequency of these assessments depends on the histological type (seminoma versus non-seminoma), the stage of the cancer, and the previous treatments (e.g., retroperitoneal lymph node dissection versus observation). Clinicians should consult national and international guidelines when determining the appropriate monitoring plan. The frequency of follow-up evaluation is reduced over several years, if there is no evidence of recurrent disease.
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