Loriot Yohann, Fizazi Karim
Département de médecine, institut Gustave-Roussy, Villejuif Cedex.
Rev Prat. 2007 Feb 28;57(4):379-84.
Stage 1 is currently the most frequent pattern at diagnosis of germ-cell tumours. Prognosis is excellent and different options are available after orchidectomy. The therapeutic choice should be taken after fair and extensive information regarding the limitations of each option therefore taking into account both predictive factors of relapse and patient individual willing. In case of pure seminoma, prophylactic radiotherapy directed to the retroperitoneal lymph nodes, chemotherapy by single-agent carboplatin and surveillance with differed treatment at relapse are the three currently available attitudes. In non-seminomatous germ cell tumours three options should also be considered: surveillance (watchful waiting), chemotherapy by two cycles of BEP, or retroperitoneal lymph node dissection.
1期是目前生殖细胞肿瘤诊断时最常见的模式。预后良好,睾丸切除术后有不同的选择。治疗选择应在充分且广泛了解每种选择的局限性后做出,因此要考虑复发的预测因素和患者的个人意愿。对于纯精原细胞瘤,针对腹膜后淋巴结的预防性放疗、单药卡铂化疗以及复发时进行不同治疗的监测是目前可用的三种方法。对于非精原细胞性生殖细胞肿瘤,也应考虑三种选择:监测(密切观察等待)、两周期BEP化疗或腹膜后淋巴结清扫术。