Division of Internal Medicine.
Division of Hematology & Medical Oncology - Melvin and Bren Simon Cancer Center, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Curr Opin Oncol. 2020 May;32(3):250-255. doi: 10.1097/CCO.0000000000000619.
Although testicular cancer remains a highly curable malignancy, challenges and uncertainty still remain in certain aspects of management. Residual disease after chemotherapy in patients with germ cell tumors (GCT) remains one of these challenges. We aim to highlight the recent literature on the management of residual disease after chemotherapy in GCT and the emerging innovations that may provide further guidance into this area.
A subset of patients with GCT will have residual disease after chemotherapy, and management of these patients involves highly skilled multidisciplinary experts including medical oncologists, surgeons, radiologists, and pathologists. Management options depend on histologic subtype, either seminoma or nonseminoma, and involve size criteria, possible further imaging modalities, and tumor markers. Even with these tools at highly specialized expert centers, uncertainty in management remains, and recent literature has explored the use of newer biomarkers to aid in these cases.
Postchemotherapy residual masses in GCT can prove to be complicated cases to manage. Balancing survival with quality of life outcomes is important and requires a multidisciplinary team experienced in treating GCT.
尽管睾丸癌仍然是一种高度可治愈的恶性肿瘤，但在某些管理方面仍存在挑战和不确定性。生殖细胞瘤（GCT）患者化疗后残留疾病就是其中的挑战之一。我们旨在强调最近关于 GCT 化疗后残留疾病管理的文献，并探讨新兴创新方法，为该领域提供进一步指导。
GCT 患者中有一部分患者在化疗后会出现残留疾病，这些患者的管理涉及包括肿瘤内科医生、外科医生、放射科医生和病理科医生在内的高度专业的多学科专家。管理方案取决于组织学亚型，包括精原细胞瘤或非精原细胞瘤，并涉及大小标准、可能的进一步影像学检查方法和肿瘤标志物。即使在高度专业化的专家中心拥有这些工具，管理方面仍存在不确定性，最近的文献探讨了使用新型生物标志物来辅助这些病例。
GCT 化疗后残留肿块可能是复杂的病例，需要平衡生存和生活质量。这需要一支在治疗 GCT 方面经验丰富的多学科团队。
