title: Advanced testis cancer.
abstract: Advanced testis tumors are highly curable. The treatment strategy is chemotherapy followed by the surgical exeresis of residual disease. The standard chemotherapy regimen is BEP (bleomycin, etoposide, and cisplatin); the number of cycles of chemotherapy depends upon prognostic factors, based on the primary site, histology, presence of visceral metastases, and serum tumor marker levels. Patients in the good-risk group receive three cycles of chemotherapy, whereas those in the intermediate- and high-risk groups receive four cycles. Exeresis of all residual disease and systematic postchemotherapy retroperitoneal dissection in bulky disease are mandatory. When complete exeresis of necrotic tissue, teratoma, or active germ-cell cancer has been performed, no further postsurgical treatment is warranted. A multidisciplinary approach, rigorous administration of chemotherapy, and skill in surgery of germ-cell tumors are favored in the treatment of these patients in trained centers.
authors.affiliation: Department of Medical Oncology, Centre Léon-Bérard, 28 rue Laënnec, 68008, Lyon, France. jpdroz@wanadoo.fr
authors.forename: J P
authors.initials: JP
authors.lastname: Droz
authors.forename: M
authors.initials: M
authors.lastname: Rivoire
mesh_terms: D000465:Algorithms; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000097:blood; D003131:Combined Modality Therapy; D004812:Epidemiologic Methods; D007172:Erectile Dysfunction / Q000517:prevention & control; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000532:radiotherapy; D008297:Male; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D009919:Orchiectomy / Q000009:adverse effects; D011183:Postoperative Complications / Q000517:prevention & control; D011379:Prognosis; D011836:Radiation Tolerance; D012186:Retroperitoneal Neoplasms / Q000556:secondary / Q000628:therapy; D012307:Risk Factors; D016879:Salvage Therapy; D018239:Seminoma / Q000401:mortality / Q000473:pathology / Q000628:therapy; D015996:Survival Rate; D013736:Testicular Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor