Steffens J, Treiyer A, Calaminus G
Klinik für Urologie und Kinderurologie, St. Antonius-Hospital, Dechant-Deckers-Strasse 8, 52249, Eschweiler, Deutschland.
Urologe A. 2009 Apr;48(4):359-63. doi: 10.1007/s00120-009-1944-1.
Based on findings from the Prepubertal Testis Tumor Registry by the Urologic Section of the American Academy of Pediatrics and collaborative data in the literature, a modern algorithm for the surgical management of prepubertal testis tumors is presented. Following testicular surgery, patients with universally benign tumors, such as teratoma, may be released from oncological follow-up. Children with stage I yolk sac tumors should be monitored closely with periodic AFP tumor marker evaluation and imaging according to the primary dissemination (e.g., ultrasound, chest x-ray, and computed tomography). Patients with recurrent or metastatic yolk sac tumors should be treated with platinum-based chemotherapy and appropriate follow-up. Retroperitoneal lymph node dissection is not recommended except for patients with residual retroperitoneal masses following chemotherapy. Aggressive treatment is warranted for metastatic Sertoli cell and metastatic undifferentiated stromal tumors.
根据美国儿科学会泌尿外科分会青春期前睾丸肿瘤登记处的研究结果以及文献中的协作数据，提出了一种青春期前睾丸肿瘤外科治疗的现代算法。睾丸手术后，患有普遍良性肿瘤（如畸胎瘤）的患者可能无需进行肿瘤学随访。I期卵黄囊瘤患儿应通过定期检测甲胎蛋白肿瘤标志物并根据原发扩散情况进行影像学检查（如超声、胸部X光和计算机断层扫描）来密切监测。复发性或转移性卵黄囊瘤患者应接受铂类化疗并进行适当的随访。除化疗后仍有腹膜后肿块残留的患者外，不建议进行腹膜后淋巴结清扫术。对于转移性支持细胞瘤和转移性未分化间质瘤，需要积极治疗。
