The Absolute Effect / Evidence / German Testicular Cancer Study Group AH 01/94
Germ Cell Tumours · Medical Oncology · Stage I Non-seminoma

German Testicular Cancer Study Group AH 01/94

Clinical question

In stage I non-seminoma, does one cycle of BEP provide better disease control than RPLND?

Trial context
Population
382 patients with clinical stage I non-seminomatous germ-cell tumours
Intervention
One cycle BEP vs nerve-sparing RPLND
Key endpoint
Recurrence-free survival
Time horizon / follow-up
Mean follow-up 4.7 years
Absolute Effect

What changes for patients?

One cycle of BEP produced fewer recurrences than RPLND in this randomized trial: 1.15% vs 7.5%, an absolute reduction of 6.35 percentage points (NNT 16). Tumour-specific survival was 100% in both groups. NNT is based on recurrence by approximately 4.7 years.

NNT: 16

Treatment burden / harm

Treatment-specific morbidity

NNH: Not quantifiable from the primary publication; RPLND carries operative morbidity while BEP carries chemotherapy-related toxicity

Relative effect

HR: Recurrence 1.15% vs 7.5%

P=.0033; tumour-specific survival 100% in both arms

Clinical interpretation

One-cycle BEP reduced relapse compared with nerve-sparing RPLND in this randomized stage I NSGCT trial, while surveillance remains a valid option for many compliant patients.

Primary publication

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Current-practice context · reviewed 14 October 2026

For clinical stage I NSGCT, surveillance is appropriate for many patients who can adhere to follow-up; one-cycle BEP and nerve-sparing RPLND are alternatives for selected patients after discussing relapse risk, late chemotherapy effects, fertility, surgical morbidity and patient preference. The randomized comparison does not make one strategy mandatory for every patient, and management should follow current stage- and risk-adapted guidance in an experienced germ-cell tumour service.

German Testicular Cancer Study Group AH 01/94 primary/long-term source ↗ · Current guideline guidance ↗