title: Contralateral biopsies in patients with testicular germ cell tumours: What is the rationale?
abstract: BACKGROUND
  In 1979, the Copenhagen group around Dr. Skakkebaek introduced contralateral biopsy in patients with testicular germ cell tumour (GCT) as a means of early diagnosing a contralateral testicular tumour (Berthelsen et al. in Br Med J 2(6186):363-364, 1). Although the rationale of contralateral biopsies is based on much of scientific evidence, no issue regarding the management of GCTs has been more controversial than the issue of contralateral biopsies (Heidenreich in BJU Int 104(9 Pt B):1346-1350, 2; Grigor and Rorth in Eur Urol 23(1):129-135, 3). A poll conducted during the GCT Consensus Meeting in Berlin 2011 revealed that 43 % of 60 leading experts would not recommend a contralateral biopsy and only 13.7 % would do the biopsy in all cases with GCT (Beyer et al. in Ann Oncol 24(4):878-888, 4). Likewise, the European Association of Urology and the European Society of Medical Oncology offer only weak recommendations with respect to contralateral biopsies in their guidelines of testicular cancer (Albers et al. in Eur Urol 68(6):1054-1068, 5; Oldenburg et al. in Ann Oncol 24(Suppl 6):vi125-vi132, 6).
  
  
  CONCLUSIONS
  This review summarizes contemporary knowledge regarding contralateral biopsies to provide professionals caring for GCT patients with sufficient information to decide for or against the procedure in clinical practice.
authors.affiliation: Department of Oncology, Akershus University Hospital, Sykehusveien 25, 1478, Lørenskog, Norway. Jan.Oldenburg@medisin.uio.no.|Faculty of Medicine, University of Oslo, Oslo, Norway. Jan.Oldenburg@medisin.uio.no.
authors.forename: Jan
authors.initials: J
authors.lastname: Oldenburg
authors.affiliation: Albertinen-Krankenhaus Hamburg, Klinik für Urologie, Suentelstrasse 11a, 22457, Hamburg, Germany.
authors.forename: Klaus-Peter
authors.initials: KP
authors.lastname: Dieckmann
mesh_terms: D001706:Biopsy / Q000379:methods*; D006801:Humans; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000175:diagnosis / Q000473:pathology*; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis / Q000473:pathology*; D011230:Precancerous Conditions / Q000175:diagnosis / Q000473:pathology*; D013736:Testicular Neoplasms / Q000175:diagnosis / Q000473:pathology*
keywords: CIS Carcinoma in situ; Cancer prevention; GCNIS; Germ cell neoplasia in situ; Infertility; Non-seminoma; Seminoma; Testicular biopsy; Testicular cancer