 High-risk stage 1 NSGCTTs are curable with careful surveillance followed by 3 cycles of BEP bleomycin, etoposide, cisplatin with 500mgm2 of etoposide per cycle chemotherapy for the 40-50 of cases experiencing recurrence. Alternatively, adjuvant chemotherapy with 2 cycles of BEPat a lower dose than that used for advanced disease - etoposide 360mgm2 for these patients achieves the same outcome and avoids intensive surveillance, but delivers 33 more chemotherapy cycles on a population basis. 