Advanced testis cancer.
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.
Droz
J P
JP
Department of Medical Oncology, Centre Léon-Bérard, 28 rue Laënnec, 68008, Lyon, France. jpdroz@wanadoo.fr
Rivoire
M
M
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
D014408:Biomarkers, Tumor