Open questions to be addressed in the
future
The standardization of diagnostic assessment, risk stratification and
therapy as well as participation in international registries will
advance the knowledge of the biology and the clinical behaviour of
SCSTs. However, due to rarity and heterogeneity of these tumors,
randomized therapeutic studies will be impossible, even at the
international level. Thus, research will have to focus on biological
studies that may reveal the genetic basis of tumor development and risk
constellations within tumor predisposition syndromes. Moreover, for
testicular SCSTs, the evaluation of surgical data may address whether
testis sparing may be feasible and safe. In contrast, the focus in
OSCSTs will remain in the optimal risk stratification in tumors with
high-risk histology and stage IC tumors. Last, effective salvage
strategies must be developed in the context of the growing genetic and
biological data on the rare cases of recurrent ovarian SCSTs, which have
a very unfavourable prognosis.