Testicular germ-cell cancer.
Testicular germ-cell tumours (TGCTs) represent the model of a curable malignancy; sensitive tumour markers, accurate prognostic classification, logical series of management trials, and high cure rates in both seminomas and non-seminomas have enabled a framework of effective cancer therapy. Understanding the molecular biology of TGCT could help improve treatment of other cancers. The typical presentation in young adults means that issues of long-term toxicity become especially important in judging appropriate management. A focus of recent developments has been to tailor aggressiveness of treatment to the severity of the prognosis. Recent changes affect the most common subtypes and include the reduction of chemotherapy for patients who have metastastic non-seminomas and a good prognosis, and alternatives to adjuvant radiotherapy in stage I seminomas. We summarise advances in the understanding and management of TGCT during the past decade.
Horwich
Alan
A
Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Surrey SM2 5PT, UK. alan.horwich@icr.ac.uk
Shipley
Janet
J
Huddart
Robert
R
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008967:Molecular Biology; D009373:Neoplasms, Germ Cell and Embryonal / Q000188:drug therapy / Q000235:genetics / Q000473:pathology; D009919:Orchiectomy; D011379:Prognosis; D016879:Salvage Therapy; D018239:Seminoma / Q000188:drug therapy / Q000235:genetics / Q000473:pathology; D013736:Testicular Neoplasms / Q000188:drug therapy / Q000235:genetics / Q000473:pathology
D000970:Antineoplastic Agents