grade police maroc colonel
Dieckmann KP, Anheuser P, Schmidt S, . The long-term follow-up for patients with stage I nonseminoma without risk factors includes history and physical examination, serum tumor marker assessment, abdominal/pelvic CT scan, and chest X-ray. Impact of long-term serum platinum concentrations on neuro- and ototoxicity in cisplatin-treated survivors of testicular cancer. Surveillance in stage I nonseminomatous germ cell tumours of the testis, Long-term follow-up of Anglian Germ Cell Cancer Group surveillance versus patients with stage 1 nonseminoma treated with adjuvant chemotherapy, Retroperitoneal lymph node dissection in patients with low stage testicular cancer with embryonal carcinoma predominance and/or lymphovascular invasion, Randomized phase III trial comparing retroperitoneal lymph node dissection with one course of bleomycin and etoposide plus cisplatin chemotherapy in the adjuvant treatment of clinical stage I nonseminomatous testicular germ cell tumors: AUO trial AH 01/94 by the German Testicular Cancer Study Group, Risk-adapted treatment in clinical stage I nonseminomatous germ cell testicular cancer: the SWENOTECA management program, Retroperitoneal lymph node dissection for nonseminomatous germ cell testicular cancer: impact of patient selection factors on outcome, Fertility and sexual function following orchiectomy and 2 cycles of chemotherapy for stage I high risk nonseminomatous germ cell cancer, Long-term efficacy of two cycles of BEP regimen in high-risk stage I nonseminomatous testicular germ cell tumors with embryonal carcinoma and/or vascular invasion, No longer any role for routine follow-up chest x-rays in men with stage I germ cell cancer, Routine chest X-rays have no additional value in the detection of relapse during routine follow-up of patients treated with chemotherapy for disseminated non-seminomatous testicular cancer, Patterns of relapse in patients with clinical stage I testicular cancer managed with active surveillance, Report of the long-term efficacy of two cycles of adjuvant bleomycin/etoposide/cisplatin in patients with stage I testicular nonseminomatous germ-cell tumors (NSGCT): a risk adapted protocol of the Hellenic Cooperative Oncology Group, Risk-adapted management for patients with clinical stage I non-seminomatous germ cell tumour of the testis, Management of stage I testicular germ cell tumours, Adjuvant therapy for stage IB germ cell tumors: one versus two cycles of BEP, Cardiovascular morbidity in long-term survivors of metastatic testicular cancer, Long-term toxicity of cisplatin in germ-cell tumor survivors, Evaluation of long-term toxicity in patients after cisplatin-based chemotherapy for non-seminomatous testicular cancer, Toxicities associated with cisplatin-based chemotherapy and radiotherapy in long-term testicular cancer survivors, Cumulative burden of morbidity among testicular cancer survivors after standard cisplatin-based chemotherapy: a multi-institutional study, Impact of long-term serum platinum concentrations on neuro- and ototoxicity in cisplatin-treated survivors of testicular cancer, Hearing loss before and after cisplatin-based chemotherapy in testicular cancer survivors: a longitudinal study, Neurotoxicity among survivors of testicular cancer: a population-based study, Clinical outcomes in patients with stage I non-seminomatous germ cell cancer, Three cycles of etoposide and cisplatin chemotherapy in clinical stage IS nonseminomatous testicular cancer, Nonrandomized comparison of primary chemotherapy and retroperitoneal lymph node dissection for clinical stage IIA and IIB nonseminomatous germ cell testicular cancer, RPLND or primary chemotherapy in clinical stage IIA/B nonseminomatous germ cell tumors? Instead, the NCCN Guidelines recommend managing patients with stage I nonseminoma based on the presence or absence of lymphovascular invasion (LVI), invasion of the spermatic cord, or invasion of the scrotum, which are factors known to be associated with an increased risk of relapse.35–43. Testicular Cancer, Version 2.2020, NCCN Clinical Practice Guidelines in Oncology December 2019 Journal of the National Comprehensive Cancer Network: JNCCN 17(12):1529-1554 Survival of non-seminomatous germ cell cancer patients according to the IGCC classification: an update based on meta-analysis. Four cycles of BEP vs four cycles of VIP in patients with intermediate-prognosis metastatic testicular non-seminoma: a randomized study of the EORTC Genitourinary Tract Cancer Cooperative Group. In select circumstances, an MRI can be considered to replace an abdominal/pelvic CT. All imaging in this setting is performed with contrast. Sperm banking should be discussed with patients of reproductive age, if clinically indicated, before undergoing any therapeutic intervention that may compromise fertility.28–31 If sperm banking is desired, it may be performed before orchiectomy in patients with risk factors for infertility (atrophic contralateral testicle, history of infertility), but certainly should be considered before subsequent therapy in patients who desire future fertility. 2019. This selection from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Testicular Cancer focuses on the diagnosis and management of nonseminomatous GCTs (to view the complete and most recent version of these guidelines, visit NCCN.org). The NCCN guidelines advise that follow-up for seminoma should be modified for the individual patient and may be extended beyond 5 years. Updates in Version 1.2015 of the NCCN Guidelines for Testicular Cancer from Version 1.2014 include: Seminoma TEST-3 • Stage IA, IB Primary treatment For single-agent carboplatin, the category was changed from a 1 to a 2A. Feldman DR, Sheinfeld J, Bajorin DF, . Urology 2004;63:556–561. The management of patients with stage IS nonseminoma after primary treatment with chemotherapy is described subsequently (see “Management of Good, Intermediate, and Poor-Risk Nonseminoma After Chemotherapy,” page 1544). Risk-adapted treatment in clinical stage I nonseminomatous germ cell testicular cancer: the SWENOTECA management program. Therefore, the NCCN panel encourages patients with metastatic, recurrent, or platinum-refractory testicular GCTs to participate in well-designed clinical trials investigating novel therapeutic strategies to enable further advances for the management of this disease. Mismatch repair deficiency predicts response of solid tumors to PD-1 blockade. Am J Clin Oncol 2015;38:373–376. Long-term follow-up of Anglian Germ Cell Cancer Group surveillance versus patients with stage 1 nonseminoma treated with adjuvant chemotherapy. J Clin Oncol 2001;19:2020–2025. High-dose chemotherapy and stem-cell rescue for metastatic germ-cell tumors. For patients with no residual mass or a residual mass <1 cm, surveillance is recommended. Lv ZJ, Wu S, Dong P, . When patients with a histologically “pure” seminoma have an elevated level of AFP, it is generally interpreted as meaning the tumor is a mixed GCT and that undetected nonseminomatous elements are present in addition to the seminoma.13,19–21 However, a small number of people have a chronically elevated serum AFP level, and clinicians should be cautious about starting treatment for a mildly elevated but stable AFP level. (The most recent version of these guidelines and accompanying disclosures are available at NCCN.org.). All rights reserved. Zuniga A, Kakiashvili D, Jewett MA. Both regimens are category 1 recommendations. Fosså SD, Chen J, Schonfeld SJ, . Recommended chemotherapy regimens include 2 cycles of either etoposide and cisplatin (EP; preferred) or BEP for patients with pN1 or pN2 disease64,65 and 3 cycles of BEP or 4 cycles of EP (both preferred) for patients with pN3 disease. Surveillance is the preferred option for patients with pN1 disease, and chemotherapy is the preferred option for patients with pN2 disease. Generally, decisions to treat should not be based solely on AFP values <20 ng/mL. Results of a prospective multicenter trial including quality of life assessment. Eur Urol 2018;73:560–569. Primary treatment of patients with stage IIB nonseminoma depends on postorchiectomy tumor marker levels and radiographic findings (see TEST-8, page 1533). van Dijk MR, Steyerberg EW, Habbema JD. American Society of Clinical Oncology Clinical Practice Guideline on uses of serum tumor markers in adult males with germ cell tumors. CA Cancer J Clin 2019;69:7–34. Use of PET/CT scan is not clinically indicated for nonseminoma.53,54 In select patients, brain MRI should also be performed; these patients include those with neurologic symptoms, postorchiectomy serum beta-hCG >5,000 IU/L or AFP >10,000 ng/mL, nonpulmonary visceral metastasis or extensive lung metastases. Indian J Urol 2010;26:76–81. Stage II and stage III disease treated with systemic chemotherapy should be followed by surgical resection of any residual masses. This Clinical Practice Guideline for Testicular Seminoma and Non-seminoma features epidemiology of these rare malignancies in young men, the diagnosis, management of the primary tumour, post-orchiectomy staging and risk assessment, treatment recommendations, late relapse, late … Bokemeyer C, Oechsle K, Honecker F, . Pembrolizumab, an anti-PD-1 antibody, was approved by the FDA for the treatment of patients with unresectable or metastatic MSI-H/dMMR solid tumors that have progressed after previous treatment and who have no satisfactory alternative treatment options.129 This first-ever tissue- and site-agnostic indication was based on data from phase II clinical trials that demonstrated the efficacy of pembrolizumab in MSI-H/dMMR solid tumors.130,131 In the only trial (phase II) investigating the efficacy of immunotherapy in testicular cancer, 12 patients with nonseminoma GCTs that progressed after first-line cisplatin-based chemotherapy and at least 1 salvage regimen (high-dose or conventional-dose chemotherapy) were treated with pembrolizumab.132 Two patients experienced stable disease for 28 and 19 weeks, respectively, but no partial or complete responses were seen. NCCN Academy for Excellence & Leadership in Oncology™: NCCN Virtual Annual Congress: Hematologic Malignancies™, NCCN Global Academy for Excellence & Leadership in Oncology™, Monthly Oncology Tumor Boards: A Multidisciplinary Approach to Individualized Patient Care, Mycosis Fungoides and Sezary Syndrome, April 27, New NCCN Guidelines for Pediatric Cancers: A Webinar Series, Patient Webinars - Know What Your Doctors Know, NCCN Virtual Nursing Forum: Advancing Oncology Nursing in Hematologic Malignancies™, Delivering Value for Patients Across the Oncology Ecosystem, Defining, Measuring, and Applying Quality in an Evolving Health Policy Landscape and the Implications for Cancer Care, The State of Cancer Care in America: Impact of State Policy on Access to High-Quality Cancer Care, Policy Challenges and Opportunities to Address Changing Paradigms in Cancer Care Delivery, Policy Strategies for the “New Normal” in Health care to Ensure Access to High Quality Cancer Care, NCCN Compendia, NCCN Templates, and NCCN Flash Updates, NCCN Compendium, NCCN Templates, and NCCN Flash Updates, NCCN Pharmacy Directors Forum White Paper: Operationalizing the Safe and Efficient Use of Biosimilars, NCCN Health Information Technology Licensees, NCCN Insights: Analytics, Research & Consulting, NCCN Collaboration with the National Business Group on Health, Points to Consider on the Best Practices for Biorepositories, Registries and Databases, Get Involved - Opportunities for Global Collaboration and Sponsorship, Clinical Trials at NCCN Member Institutions, Find ORP Funded Clinical Trials at NCCN Member Institutions. J Clin Oncol 2010;28:3388–3404. Huyghe E, Matsuda T, Thonneau P. Increasing incidence of testicular cancer worldwide: a review. Patients with mildly elevated and normalizing markers should be considered for surgical resection of residual masses followed by surveillance. Nonomura N, Nishimura K, Takaha N, . Kollmannsberger C, Nichols C, Bamberg M, . Oncologist 2008;13:1149–1154. Can Urol Assoc J 2015;9:381–384. Schmoll HJ, Souchon R, Krege S, . Cancer 2003;97:1624–1629. If surveillance is elected as primary management, the pelvis should be included in the imaging due to a higher risk of pelvic relapses in these patients. Culine S, Kerbrat P, Kramar A, . Request PDF | On Jun 1, 2009, Robert J Motzer and others published NCCN clinical practice guidelines in oncology: testicular cancer | Find, read and cite all the research you need on ResearchGate George DW, Foster RS, Hromas RA, . Chemotherapy for Testicular Cancer High-Dose Chemotherapy and Stem Cell Transplant for Testicular Cancer Common treatment approaches In recent years, a lot of progress has been made in treating testicular cancer. RPLND is preferred as primary treatment of stage I or II tumors with transformed teratoma and should be considered for stage II tumors with teratoma predominance if serum tumor markers are normal. If embryonal, yolk sac, choriocarcinoma, or seminoma elements are found in the residual mass, then 2 cycles of chemotherapy with EP; paclitaxel, ifosfamide, and cisplatin (TIP); VIP; or vinblastine, ifosfamide, and cisplatin (VelP) should be administered. Maintaining success, reducing treatment burden, focusing on survivorship: highlights from the third European consensus conference on diagnosis and treatment of germ-cell cancer. The frequency of these tests varies with the primary treatment modality received by the patient (see Tables 6 and 7, pages 1541 and 1542, respectively). Therefore, patients who choose surveillance should adhere to the follow-up schedule. Eur Urol 2004;46:209–215. Oncological outcomes in patients with stage I testicular seminoma and nonseminoma: pathological risk factors for relapse and feasibility of surveillance after orchiectomy. Nerve-sparing dissection techniques preserve antegrade ejaculation in 90% of cases.55 Therefore, nerve-sparing RPLND is recommended. Combination chemotherapy with gemcitabine plus oxaliplatin in patients with intensively pretreated or refractory germ cell cancer: a study of the German Testicular Cancer Study Group. BMC Urol 2015;15:16. Familial testicular germ cell tumors in adults: 2010 summary of genetic risk factors and clinical phenotype. At the beginning of each NCCN Guidelines Panel meeting, panelmembers reviewall potential conflicts of interest.NCCN, in keeping with its commitment to public transparency, publishes these disclosures for panel members, staff, and NCCN itself. This means that one or both testicles fail to move from the abdomen (belly) into the scrotum before birth. Testicular Cancer. Toxicities associated with cisplatin-based chemotherapy and radiotherapy in long-term testicular cancer survivors. Outcomes of surveillance protocol of clinical stage I nonseminomatous germ cell tumors-is shift to risk adapted policy justified? NCCN Guidelines Version 1.2011 The NCCN Clinical Practice Guidelines for the treatment of testicular cancer have been updated to v.1.2011. No longer any role for routine follow-up chest x-rays in men with stage I germ cell cancer. Ann Oncol 2008;19:448–453. Surgical management of complex residual masses following systemic chemotherapy for metastatic testicular germ cell tumours. Ann Oncol 2017;28:362–367. Disclosures for the NCCN Gestational Trophoblastic Neoplasia Panel. Feldman DR, Lorch A, Kramar A, . Version 1.2015. Privacy Policy| This selection from the NCCN Guidelines for Testicular Cancer focuses on recommendations for the management of adult patients with nonseminomatous GCTs. The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) are a statement of evidence and consensus of the authors regarding their views of currently accepted approaches to treatment. The serum tumor markers alpha-fetoprotein (AFP) and beta-human chorionic gonadotropin (beta-hCG) are critical in determining prognosis and assessing treatment outcomes in patients with testicular GCTs. Staging of testicular GCTs is based on determination of the extent of disease and assessment of postorchiectomy levels of serum tumor markers.12 The tumor (T), node (N), and metastasis (M) staging system used by the AJCC is the internationally accepted standard for cancer staging and is a major factor influencing prognosis and treatment decisions. Clinical trial enrollment is also an option for patients with unresectable late relapse. Because RPLND is likely a curative procedure in patients with pN0 disease, surveillance is recommended for this group. Available at: Mismatch repair deficiency predicts response of solid tumors to PD-1 blockade, PD-1 blockade in tumors with mismatch-repair deficiency, Phase II trial of pembrolizumab in patients with platinum refractory germ-cell tumors: a Hoosier Cancer Research Network Study GU14-206, Brain metastases in patients with germ cell tumors: prognostic factors and treatment options-an analysis from the global germ cell cancer group, European consensus on diagnosis and treatment of germ cell cancer: a report of the European Germ Cell Cancer Consensus Group (EGCCCG), Maintaining success, reducing treatment burden, focusing on survivorship: highlights from the third European consensus conference on diagnosis and treatment of germ-cell cancer, Management of brain metastases from germ cell tumors: a single center experience, Patterns of relapse in poor-prognosis germ-cell tumours in the GETUG 13 trial: Implications for assessment of brain metastases, First-line high-dose chemotherapy +/- radiation therapy in patients with metastatic germ-cell cancer and brain metastases, Clinical Presentation, Workup, and Primary Treatment, Primary Treatment of Nonseminoma Stage I Without Risk Factors, Management of Nonseminoma Stage I Without Risk Factors After RPLND, Follow-up for Nonseminoma Stage I Without Risk Factors, Primary Treatment of Nonseminoma Stage I With Risk Factors, Management of Nonseminoma Stage I With Risk Factors After RPLND, Follow-up for Nonseminoma Stage I With Risk Factors, Primary Treatment of Nonseminoma Stage IS, Management of Nonseminoma Stage IS After Primary Treatment, Primary Treatment of Nonseminoma Stage IIA, Management of Nonseminoma Stage IIA After Primary Treatment, Primary Treatment of Nonseminoma Stage IIB, Management of Nonseminoma Stage IIB After Primary Treatment, Primary Treatment of Good-Risk Nonseminoma, Primary Treatment of Intermediate-Risk (Stage IIIB) Nonseminoma, Primary Treatment of Poor-Risk (Stage IIIC) Nonseminoma, Management of Good-, Intermediate-, and Poor-Risk Nonseminoma After Chemotherapy, Follow-up for Good-, Intermediate-, and Poor-RiskNonseminoma, Second-Line and Subsequent Therapy for Metastatic Germ Cell Tumors, Management of Metastatic Germ Cell Tumors After Second-Line Therapy, NCCN CATEGORIES OF EVIDENCE AND CONSENSUS, https://seer.cancer.gov/statfacts/html/testis.html, https://doi.org/10.1007/978-3-319-40618-3, https://www.fda.gov/drugs/informationondrugs/approveddrugs/ucm560040.htm. Second-line therapy options for patients with early relapses (within 2 years of the completion of primary therapy) include enrollment in a clinical trial (preferred), conventional-dose chemotherapy, or high-dose chemotherapy (see TEST-13, page 1538). Management of brain metastases from germ cell tumors: a single center experience. Adverse surgical outcomes associated with robotic retroperitoneal lymph node dissection among patients with testicular cancer. Lago-Hernandez CA, Feldman H, O’Donnell E, . The recommended third-line palliative chemotherapy options for patients with intensively pretreated, cisplatin-resistant, or refractory GCTs are combinations of gemcitabine with paclitaxel and/or oxaliplatin,121–127 or oral etoposide.128 The recommendation for gemcitabine and oxaliplatin (GEMOX) is based on data from phase II studies investigating the efficacy and toxicity of GEMOX in patients with relapsed or cisplatin-resistant GCTs.122,124,126 These studies showed that GEMOX is safe for patients with cisplatin-resistant testicular GCTs and may offer a chance of long-term survival.122,124,126 Gemcitabine and paclitaxel is another option that has shown promising results in a phase II study.123 Follow-up results showed long-term disease-free survival in patients who showed progression after high-dose chemotherapy and who had not received prior paclitaxel or gemcitabine.125 A phase II study of patients with treatment-resistant GCTs also found the combination of gemcitabine, oxaliplatin, and paclitaxel to be effective with acceptable toxicity.121 The overall response rate was 51% with 5% of patients experiencing a complete response. Updates in Version 1.2015 of the NCCN Guidelines for Testicular Cancer from Version 1.2014 include: Seminoma TEST-3 • Stage IA, IB Primary treatment For single-agent carboplatin, the category was changed from a 1 to a 2A. Patients with recurrent disease who have not been treated with prior chemotherapy should be managed per their risk status, as described in the preceding sections. N Engl J Med 2007;357:340–348. Randomized trial comparing bleomycin/etoposide/cisplatin with alternating cisplatin/cyclophosphamide/doxorubicin and vinblastine/bleomycin regimens of chemotherapy for patients with intermediate- and poor-risk metastatic nonseminomatous germ cell tumors: Genito-Urinary Group of the French Federation of Cancer Centers Trial T93MP. J Clin Oncol 2016;34:345–351. Nonseminomatous GCTs include nonseminoma tumors, mixed seminoma/nonseminoma tumors, and seminoma tumors in patients with elevated serum AFP levels. Legal Notices| Limited post-chemotherapy retroperitoneal resection of residual tumour in non-seminomatous testicular cancer: complications, outcome and quality of life. Therefore, decisions regarding treatment should not be made based on mildly elevated (<3 × upper limit of normal) LDH alone. These NCCN Guidelines® are currently available as Version 1.2019. Accessed September 5, 2019. If abnormal radiographic findings are limited to lymph node metastases within lymphatic drainage sites in the retroperitoneum (ie, the landing zone), patients may receive primary chemotherapy with either 3 cycles of BEP or 4 cycles of EP (both preferred; see TEST-E, page 1545) or primary nerve-sparing RPLND (reserved for highly selected cases). Classification, epidemiology and therapies for testicular germ cell tumours. The long-term follow-up for patients with stage I nonseminoma with risk factors includes history and physical examination, serum tumor marker assessment, chest X-ray, and abdominal/pelvic CT scan. International Germ Cell Cancer Collaborative Group. Adv Urol 2018;2018:7272541. Postchemotherapy surgery for germ cell tumors–what have we learned in 35 years? Albers P, Siener R, Kliesch S, . Furthermore, involvement of the brain was more common among patients who were previously treated with high-dose chemotherapy (29%) compared with BEP (12%). J Clin Oncol 2010;28:537–542. Eur Urol 2011;59:556–562. Greene MH, Kratz CP, Mai PL, . Histopathology 2018;73:741–747. Endocr Relat Cancer 2010;17:R109–R121. The NCCN Categories of Preference have been applied to all of the … Primary chemotherapy for stage II nonseminomatous germ cell tumors of the testis. Oncologist 2014;19:498–506. Horwich A, Norman A, Fisher C, . Yossepowitch O, Aviv D, Wainchwaig L, . J Clin Oncol 2018;36:1505–1512. In addition, a thorough history and physical examination should be performed. Calaway AC, Einhorn LH, Masterson TA, . Saito K, Suzuki K, Iwasaki A, . For patients with a partial response to second-line therapy (as indicated by residual masses on CT scan) and normal marker levels, surgical resection of all residual masses is recommended followed by surveillance. Clin Cancer Res 2016;22:1265–1273. Phase II study of paclitaxel plus gemcitabine salvage chemotherapy for germ cell tumors after progression following high-dose chemotherapy with tandem transplant. Combination of paclitaxel, ifosfamide, and cisplatin is an effective second-line therapy for patients with relapsed testicular germ cell tumors. Can J Urol 2005;12:2575–2580. The average 5-year survival rate is 95%. Le DT, Uram JN, Wang H, . Levels of serum tumor markers should also be measured. The study showed 6 grade-3 adverse events, but no immune-related adverse events were reported. Rarely, a teratoma may contain elements of a somatic cancer, such as a sarcoma or adenocarcinoma, and it is then referred to as a “teratoma with somatic type malignancy.”. Testicular hilum and vascular invasion predict advanced clinical stage in nonseminomatous germ cell tumors. Brain metastases from testicular GCTs are relatively rare and occur almost exclusively in patients with nonseminoma histology.133 The development of brain metastases may be more common in patients with a higher burden of systemic disease; lung, liver, and/or bone metastases; high levels of serum beta-hCG (>5,000 IU/L); and in those who experience relapse after cisplatin-based chemotherapy. Randomized comparison of cisplatin and etoposide and either bleomycin or ifosfamide in treatment of advanced disseminated germ cell tumors: an Eastern Cooperative Oncology Group, Southwest Oncology Group, and Cancer and Leukemia Group B Study. J Urol 2000;163:796–801. This document presents a limited update of the 2018 publication. Am J Clin Oncol 2014;37:356–359. Einhorn LH, Williams SD, Chamness A, . In patients with clinical stage I seminoma, the National Comprehensive Cancer Network (NCCN) recommends surveillance with history and physical examination (H&P) and … Vinblastine plus ifosfamide plus cisplatin as initial salvage therapy in recurrent germ cell tumor, Combination of paclitaxel, ifosfamide, and cisplatin is an effective second-line therapy for patients with relapsed testicular germ cell tumors, Salvage chemotherapy with paclitaxel, ifosfamide, and cisplatin (TIP) in relapsed or cisplatin-refractory germ cell tumors, Paclitaxel, ifosfamide, and cisplatin (TIP) as salvage and consolidation chemotherapy for advanced germ cell tumor, High-dose chemotherapy and stem-cell rescue for metastatic germ-cell tumors, TI-CE high-dose chemotherapy for patients with previously treated germ cell tumors: results and prognostic factor analysis, Salvage surgery of chemorefractory germ cell tumors with elevated tumor markers, Update on late relapse of germ cell tumor: a clinical and molecular analysis, Ongoing clinical trials in testicular cancer: the TIGER trial, Conventional-dose versus high-dose chemotherapy as first salvage treatment in male patients with metastatic germ cell tumors: evidence from a large international database, Conventional-dose versus high-dose chemotherapy for relapsed germ cell tumors, Combination chemotherapy with gemcitabine, oxaliplatin, and paclitaxel in patients with cisplatin-refractory or multiply relapsed germ-cell tumors: a study of the German Testicular Cancer Study Group, Phase II study of oxaliplatin and gemcitabine salvage chemotherapy in patients with cisplatin-refractory nonseminomatous germ cell tumor, Phase II study of paclitaxel plus gemcitabine salvage chemotherapy for germ cell tumors after progression following high-dose chemotherapy with tandem transplant, Combination chemotherapy with gemcitabine plus oxaliplatin in patients with intensively pretreated or refractory germ cell cancer: a study of the German Testicular Cancer Study Group, Long-term survival with paclitaxel and gemcitabine for germ cell tumors after progression following high-dose chemotherapy with tandem transplant, Gemcitabine and oxaliplatin (GEMOX) in patients with cisplatin-refractory germ cell tumors: a phase II study, Efficacy and safety of gemcitabine, oxaliplatin, and paclitaxel in cisplatin-refractory germ cell cancer in routine care–registry data from an outcomes research project of the German Testicular Cancer Study Group, Phase II study of daily oral etoposide in refractory germ cell tumors. Albers P, Ganz A, Hannig E, . The NCCN testicular cancer guideline was updated on November 20, 2019, and this version was used in our analysis. Patients with a partial response to second-line therapy (residual masses) and abnormal marker levels should be managed according to the kinetics of the tumor markers (see TEST-14, page 1539). de Wit M, Brenner W, Hartmann M, . de Wit R, Roberts JT, Wilkinson PM, . Elevated serum concentrations of beta-hCG may be present with both seminomatous and nonseminomatous tumors. Huddart RA, O’Doherty MJ, Padhani A, . Updates in Version 2.2019 of the NCCN Guidelines for Penile Cancer from Version 1.2019 include: MS-1 • The discussion section has been updated to reflect the changes in the algorithm. Observation versus adjuvant radiation or chemotherapy in the management of stage I seminoma: clinical outcomes and prognostic factors for relapse in a large US cohort. Retroperitoneal lymph node dissection for nonseminomatous germ cell testicular cancer: impact of patient selection factors on outcome. Both options of primary chemotherapy or primary nerve-sparing RPLND are comparable in terms of outcome, but side effects and toxicity are different.85 The reported relapse-free survival with either approach is close to 98%.88–90,92,93 If metastatic disease (based on radiographic findings) is not confined to within the lymphatic drainage sites (ie, multifocal or symptomatic lymph node metastases with aberrant lymphatic drainage sites), primary chemotherapy (3 cycles of BEP or 4 cycles of EP; both preferred) is recommended.
Live Score Biathlon, Coloriage Par Numéro En Ligne, Hotel Angers Premiere Classe, Pere Supérieur En 4 Lettres, Personnage One Piece Clown, Urgence Clinique St Paul Martinique,
About the author