From Germ Cell Histogenesis to Precision Risk Stratification: Prognostic and Predictive Molecular Markers in Testicular Germ Cell Tumors—A Systematic Review

Background/Objectives: Testicular germ cell tumors (TGCTs) represent the most common solid malignancies in young adult men, with cure rates exceeding 95% under modern cisplatin-based therapy, yet a clinically relevant subset of patients still experiences treatment failure or long-term toxicity. This systematic review synthesizes peer-reviewed evidence, from database inception through 6 July 2026, on prognostic and predictive molecular markers in developmental and endocrine-sensitive testicular carcinogenesis.

Methods

A PRISMA 2020-aligned search of MEDLINE/PubMed, Embase, Web of Science Core Collection, and the Cochrane Library was supplemented by registry-based evidence, reference-list screening, and contemporary guidelines to capture diagnostic, prognostic, and predictive biomarkers in TGCTs. The strategy encompassed classical serum markers, tissue-based molecular and immunohistochemical markers, miRNA/cfDNA liquid-biopsy assays, immune and resistance-related features, and validated clinicopathological risk models.