Most of the studies on advanced germinal cancer include both seminoma and nonseminomatous tumors [
78]. There is no evidence that their chemosensitivity is any different [
79,
80]. As there is no bad prognostic subtype for advanced pure seminomas, most of the centers tend to treat them in the same way as the bad prognostic subtypes of nonseminoma. The current standard treatment consists of 3-4 cycles of BEP or EP CHT [
5,
34]. The most recent European consensus evaluates the risk of complications [
11]. The retrospective Dutch study of Belt-Dusebout et al. establishes the risk of secondary cancer and cardiovascular complications following the treatment of testicular cancer in general and after CHT in particular [
81]. Cisplatin dose-intensified CHT does not seem to be superior to standard BEP or RT [
82]. Post therapeutic follow-up modalities consist of a four-week post CHT thoraco-abdomino-pelvic CT-scan [
5]. The subsequent management depends on the size of the residual mass. If the latter is less than 3 cm in diameter, a simple surveillance in advised. If it is larger, a PET/CT exam is recommended. If the latter remains positive, a definitive confirmation by biopsy is necessary. If the PET/CT is negative, surveillance may be sufficient [
33,
83]. In the presence of active residual tumoral tissue, RT or CHT remains the treatment of choice [
5,
33].
