Regardless of the treatment option selected for management of low-stage @entity5 , ultimate survival is nearly identical. Treatment-related morbidity is very low regardless of management modality and the individual @entity1 can expect similar physical limitations owing to therapy. The overall difference in loss of productivity between treatment programs varies by little more than 1 week. The cost of treatment is similar for all methods, although there is a definite financial advantage to surveillance, less so for selective surveillance, when compared with other forms of management. Socioeconomic factors are of importance when managing limited resources for a large population, but are of less concern to an individual, especially when the mean differences in per @entity1 costs vary by only  5000. Because of these close similarities in efficacy, morbidity, and costs treatment decisions should be individualized. A responsible and reliable @entity1 can be managed safely by selective surveillance. Those individuals considered to be less self-motivated to pursue intensive care should be managed by primary therapy. Without more information regarding the long-term outcomes associated with primary adjuvant chemotherapy, primary adjuvant RPLND, where experienced surgical support is available, is the preferred management for low-stage @entity5 in @entity1 selected for, or electing, active treatment rather than surveillance. Active investigations examining the role of medical management in this population should be continued. Our preferred choice of initial management is to offer selective surveillance to appropriate @entity1 and modified RPLND to the remainder.

A rational approach to managing stage I nonseminomatous XXXX .

@entity5 :: ('MESH:D009369', 'Disease') :: ['germ cell cancer'] @entity1 :: ('9606', 'Species') :: ['patients', 'patient']
@entity5 :: (MESH:D009369,Disease) :: ['germ cell cancer']
