Advanced germ cell tumors in male patients.
Germ cell tumors (GCTs) in male patients are particularly important in oncology because the impact of a cure in the young patient population is significant. Patients with poor-risk tumors by the international classification system have about a 50% likelihood of long-term survival. No randomized trial has proved a chemotherapy regimen to be superior to that of four courses of combination bleomycin, etoposide, and cisplatin. Ongoing research is evaluating the role of high-dose chemotherapy and hematopoietic stem cell transplantation as initial therapy in patients with intermediate-risk and poor-risk GCT. Newer agents such as gemcitabine and paclitaxel have shown promise and may be incorporated in future chemotherapeutic regimens. We review the major prognostication systems, areas of research directed at improving treatment outcome, and approaches that will improve understanding and management of these neoplasms in the future.
Nahleh
Z
Z
Bone Marrow Transplant Program, George Washington University School of Medicine, Washington, DC, USA.
Gallardo
J
J
Tabbara
I A
IA
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D018237:Germinoma / Q000145:classification / Q000188:drug therapy* / Q000473:pathology / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D009362:Neoplasm Metastasis; D011379:Prognosis; D012008:Recurrence; D016879:Salvage Therapy / Q000379:methods; D016896:Treatment Outcome