In men who relapse while on surveillance in stage I pure seminoma testicular cancer, most relapses occur in the abdominal and pelvic lymph nodes [8-11]. The 2021 National Comprehensive Cancer Network (NCCN) guidelines recommend, apart from physical examination and serum tumor markers, imaging surveillance to detect relapse for 5 years after orchiectomy [8]. In this document, clinical suspicion of tumor relapse indicates abnormal physical examination or serum markers and no clinical suspicion of tumor relapse indicates a normal physical examination and tumor markers. The management strategies and prognosis of men with stage II and higher pure seminoma testicular cancer and nonseminoma testicular cancer, as well as restaging and follow-up approaches, are beyond the scope of this document but have been described in detail by the 2021 NCCN guidelines [8]. aOttawa Hospital Research Institute and the Department of Radiology, The University of Ottawa, Ottawa, Ontario, Canada. bPanel Chair, University of Chicago, Chicago, Illinois. cPanel Vice-Chair, Duke University Medical Center, Durham, North Carolina. dMemorial Sloan Kettering Cancer Center, New York, New York. eUniversity of Minnesota, Minneapolis, Minnesota. fUrology Clinics of North Texas, Dallas, Texas; American Urological Association. gUniversity of Wisconsin, Madison, Wisconsin. hUPMC, Pittsburgh, Pennsylvania; American Urological Association. iStanford University Medical Center, Stanford, California. jEmory University Hospital, Atlanta, Georgia. kThe Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada, Primary care physician. lNational Institutes of Health, Bethesda, Maryland. mSpecialty Chair, University of Alabama at Birmingham, Birmingham, Alabama. The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through representation of such organizations on expert panels.
Staging and Surveillance of Testicular Cancer. In men who relapse while on surveillance in stage I pure seminoma testicular cancer, most relapses occur in the abdominal and pelvic lymph nodes [8-11]. The 2021 National Comprehensive Cancer Network (NCCN) guidelines recommend, apart from physical examination and serum tumor markers, imaging surveillance to detect relapse for 5 years after orchiectomy [8]. In this document, clinical suspicion of tumor relapse indicates abnormal physical examination or serum markers and no clinical suspicion of tumor relapse indicates a normal physical examination and tumor markers. The management strategies and prognosis of men with stage II and higher pure seminoma testicular cancer and nonseminoma testicular cancer, as well as restaging and follow-up approaches, are beyond the scope of this document but have been described in detail by the 2021 NCCN guidelines [8]. aOttawa Hospital Research Institute and the Department of Radiology, The University of Ottawa, Ottawa, Ontario, Canada. bPanel Chair, University of Chicago, Chicago, Illinois. cPanel Vice-Chair, Duke University Medical Center, Durham, North Carolina. dMemorial Sloan Kettering Cancer Center, New York, New York. eUniversity of Minnesota, Minneapolis, Minnesota. fUrology Clinics of North Texas, Dallas, Texas; American Urological Association. gUniversity of Wisconsin, Madison, Wisconsin. hUPMC, Pittsburgh, Pennsylvania; American Urological Association. iStanford University Medical Center, Stanford, California. jEmory University Hospital, Atlanta, Georgia. kThe Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada, Primary care physician. lNational Institutes of Health, Bethesda, Maryland. mSpecialty Chair, University of Alabama at Birmingham, Birmingham, Alabama. The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through representation of such organizations on expert panels.