Testicular cancer.
The management of testis cancer is continually changing. Since the introduction of curative chemotherapy for metastatic disease, the entire approach to early disease (stage I and stage II) is undergoing reevaluation. Individuals with favorable prognostic features can be offered, under detailed clinical protocols, orchiectomy followed by meticulous surveillance. Likewise, individuals with retroperitoneal disease may be offered retroperitoneal lymph node dissection initially or, alternatively, chemotherapy initially. The prognosis for individuals with metastatic disease is extremely favorable, with the majority of patients being cured with 9-12 weeks of combination chemotherapy. Major efforts are still underway to identify appropriate second-line or "salvage" regimens for individuals who are not cured with first-line chemotherapy. Likewise, the use of new modalities, such as bone marrow transplantation, and new drugs must be evaluated in appropriately designed, prospective studies. Such studies will continue to increase the cure rate of individuals with metastatic disease and enhance the prognosis for such high-risk populations of patients. This paper reviews basic aspects relating to histology, clinical staging, and approach to management for all stages of germ cell cancer of the testis.
Garnick
M B
MB
Department of Medicine, Dana-Farber Cancer Institute, Harvard Medical School, Cambridge, Massachusetts.
D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003131:Combined Modality Therapy; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D009919:Orchiectomy; D011878:Radiotherapy; D013736:Testicular Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*