The dramatic improvements made in the management of testicular cancer provides one of the most advances in oncology over the last decade. Many developments in chemotherapy, particularly the introduction of cis-platinum, have been largely responsible for this dramatic improvement. Although 70% of patients with disseminated testicular cancer will achieve a disease-free status with PVB or VAB-6 therapy, there still remains a patient population eligible for salvage therapy. There are still about 30% of patients who have unresectable PR (or no response at all to primary chemotherapy) and another 10% who will relapse from a chemotherapy-induced CR. Approximately 20-40% of these refractory cases can be salvaged and potentially cured with cisplatin +VP-16 or VM-26 combination salvage chemotherapy. Furthermore 10-20% of these patients are eligible for salvage surgery when serum marker results are negative. The treatment goal for this disease is cure. To achieve disease-free status, an adequate combination of chemotherapy, surgery and radiation therapy is essential.