Pedraza Adriana M, Stephenson Andrew J
Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia.
Cleveland Clinic Glickman Urological and Kidney Institute, Cleveland, Ohio, USA.
Curr Opin Urol. 2018 Sep;28(5):448-453. doi: 10.1097/MOU.0000000000000525.
Testicular germ cell tumour (TGCT) is a common malignancy among young men. There is controversy regarding the best approach for patients with clinical stage I disease due to rates of relapse with active surveillance in contrast to overtreatment with adjuvant therapy. The aim of this review is to describe the role of prognostic factors in this setting.
Molecular prognostic factors have been described as a possible future aid to clinical and histologic features in the approach of patients with clinical stage I germ cell tumours.
Prognostic factors currently available are not accurate enough and may lead to overtreatment. However, though active surveillance has shown long-term survival near to 100% in the management of clinical stage I germ cell tumours, there is a significant percentage of patients with occult metastatic disease, who benefit from adjuvant therapy. In light of these data, future research is needed to better define high-risk patients for relapse, taking into account molecular markers recently reported.
睾丸生殖细胞肿瘤（TGCT）是年轻男性中常见的恶性肿瘤。对于临床I期疾病患者的最佳治疗方法存在争议，因为主动监测存在复发率，而辅助治疗又存在过度治疗的情况。本综述的目的是描述预后因素在这种情况下的作用。
分子预后因素已被描述为未来在临床I期生殖细胞肿瘤患者治疗中辅助临床和组织学特征的一种可能手段。
目前可用的预后因素不够准确，可能导致过度治疗。然而，尽管主动监测在临床I期生殖细胞肿瘤的管理中显示长期生存率接近100%，但仍有相当比例的隐匿性转移性疾病患者可从辅助治疗中获益。鉴于这些数据，需要进一步研究，结合最近报道的分子标志物，更好地界定复发高危患者。
