Testicular tumours (nonseminomatous).
In view of the excellent results of multimodal therapy for nonseminoma testicular tumours, with chemotherapy and surgery, attempts have been made to reduce the side-effects of treatment in patients with a good prognosis, while maintaining efficacy. It is now generally accepted that surveillance after orchidectomy is suitable in patients with low-risk stage I disease. Nerve-sparing retroperitoneal lymph-node dissection as a primary treatment is a good alternative to primary chemotherapy in low-stage disease, i.e. high-risk stage I and stage IIa-b, enabling chemotherapy to be reduced by at least half, and decreasing the long-term side-effects of chemotherapy, especially cardiovascular, neuro-, nephro- and pulmonary toxicity. However, in patients with advanced disease and a poor prognosis, conventional chemotherapy is more likely to fail, and improving the treatment results by new schedules of chemotherapy (although more toxic) remains the main goal.
Oosterhof
Gosse O N
GO
Department of Urology, Academic Hospital Maastricht, the Netherlands. G.Oosterhof@urology.azm.nl
Verlind
Johan
J
D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging / Q000379:methods; D018365:Neoplasm, Residual / Q000473:pathology; D011183:Postoperative Complications / Q000209:etiology; D011379:Prognosis; D013736:Testicular Neoplasms / Q000473:pathology / Q000628:therapy*
D000970:Antineoplastic Agents