Kondagunta G Varuni, Motzer Robert J
Genitourinary Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
Urol Clin North Am. 2007 May;34(2):179-85; abstract ix. doi: 10.1016/j.ucl.2007.02.005.
Management options for patients who have stage II nonseminomatous germ cell cancer, completely resected at retroperitoneal lymph node dissection (RPLND), include two cycles of adjuvant cisplatin-based chemotherapy or close surveillance, with chemotherapy reserved for patients who relapse. Both options are associated with cure in an equally high percentage of patients. The choice of options is influenced by the extent of the tumor resected and patient compliance. Surveillance is a strong consideration for patients who have low-volume nodal disease at RPLND because the relapse proportion is 30% or less. In contrast, patients who have high-volume nodal involvement at RPLND have a relapse rate of 50% to 90% with surveillance alone, and adjuvant chemotherapy is the preferable option in this group.
对于在腹膜后淋巴结清扫术（RPLND）中已完全切除的II期非精原细胞性生殖细胞癌患者，治疗选择包括两个周期的以顺铂为基础的辅助化疗或密切监测，化疗仅用于复发患者。两种选择在相同比例的患者中都能实现治愈。选择何种方案受肿瘤切除范围和患者依从性的影响。对于在RPLND中淋巴结疾病体积较小的患者，密切监测是一个重要考虑因素，因为复发比例为30%或更低。相比之下，在RPLND中淋巴结受累体积较大的患者，仅进行监测时复发率为50%至90%，辅助化疗是该组患者的首选方案。
