title: Quality of life of survivors of testicular germ cell cancer: a review of the literature.
abstract: OBJECTIVE
  Testicular cancer (TC) affects young men in the prime of life. The excellent prognosis and an increasing incidence have led to a growing number of testicular cancer survivors (TCSs). The aim of this review was to summarize and discuss research findings on the quality of life (QOL) of TCSs in terms of physical, psychological, and social well-being.
  
  
  METHODS
  Literature databases were used to identify studies published between 1980 and 2003. A quality assessment using methodological and treatment-related criteria was performed to distinguish stronger- from poorer-quality studies.
  
  
  RESULTS
  Twenty-three studies met the inclusion criteria. Quality assessment showed that seven studies were qualitatively stronger. The majority of TCSs in both stronger and poorer quality studies reported a good QOL. Prospective and retrospective studies showed that QOL after completion of treatment increased and negative consequences of TC on life decreased compared to the situation directly after diagnosis. The stronger-quality studies reported mainly on physical and psychological well-being but did not examine social well-being and the impact of treatment-related characteristics comprehensively.
  
  
  CONCLUSIONS
  Both stronger- and poorer-quality studies indicate that the majority of TCSs experience a good QOL, but the shortcomings on both the methodological and content level prevent us from drawing such a conclusion. Additional research with strong designs is needed to gain clearer insight into the QOL of TCSs as a group and of individuals at risk for physical, psychological, and social problems.
authors.affiliation: Department of Surgical Oncology, University Hospital Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: Fleer
authors.forename: H J
authors.initials: HJ
authors.lastname: Hoekstra
authors.forename: D Th
authors.initials: DT
authors.lastname: Sleijfer
authors.forename: J E H M
authors.initials: JE
authors.lastname: Hoekstra-Weebers
mesh_terms: D000223:Adaptation, Psychological; D005260:Female; D006801:Humans; D008297:Male; D011788:Quality of Life; D012307:Risk Factors; D012649:Self Concept; D012725:Sexual Behavior / Q000523:psychology; D018454:Spouses / Q000523:psychology*; D013315:Stress, Psychological / Q000209:etiology*; D017741:Survivors / Q000523:psychology*; D013736:Testicular Neoplasms / Q000523:psychology*; D013997:Time Factors