Advances in the management of testicular cancer.
Although testicular cancer is currently a rare disease, the incidence is rising. The most important risk factor remains cryptorchism and there is a variable association with testicular microlithiasis. Serum tumor markers remain important for diagnosis, and they have prognostic value and can be used to monitor therapy and follow-up. Conventional imaging can only be improved in specific categories of patients with positron emission tomography scanning. The optimal therapy after orchiectomy should be individualized based on the histology of the primary specimen, the presence or absence of metastasis, and marker levels. An optimal definition of risk factors will likely spur the development of risk-adjusted treatment modalities and subsequently lead to better results and less toxicity. Extensive research into the molecular biology of testicular cancer is ongoing and will hopefully offer new targets for the diagnosis, staging, and treatment of testicular cancer in the future.
Balk
Cathy
C
University Medical Centre Nijmegen, Department of Urology, St Radboud, PO BOX 9101, 6500 HB Nijmegen, The Netherlands. f.witjes@uro.azn.nl
Witjes
J Alfred
JA
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000032:analysis; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D009919:Orchiectomy; D010347:Patient Care Planning; D011379:Prognosis; D012307:Risk Factors; D018239:Seminoma / Q000473:pathology / Q000601:surgery*; D013736:Testicular Neoplasms / Q000473:pathology / Q000601:surgery*
D014408:Biomarkers, Tumor