Baweja Abinav, Mar Nataliya, Rezazadeh Kalebasty Arash
Hematology/Oncology, UCI Medical Center, University of California, Orange, CA 92868, United States.
World J Clin Oncol. 2022 Jan 24;13(1):62-70. doi: 10.5306/wjco.v13.i1.62.
Late relapses of early-stage germ cell tumors are rare. Most patients (-85%) with stage I seminoma are cured by radical orchiectomy. The detection of late relapse is challenging given the relative rarity of this phenomenon, and the fact that patients who have completed surveillance are usually not undergoing regular oncologic workup nor imaging. While many treatment options do exist for a patient with late relapse of seminoma, surgery is typically the mainstay as these tumors are generally thought to be more chemo-resistant.
In this article, we describe the management of a patient with an early-stage pure seminoma who was subsequently identified to have a recurrence two decades later. We provide a review of the literature not only focused on clinical factors and biology, but also the management of late recurrences specifically in pure seminoma and in prostate gland.
There is a paucity of data and treatment recommendations for this clinical entity, and a multidisciplinary approach emphasizing subspecialty expert consultation and patient education is imperative.
早期生殖细胞肿瘤的晚期复发很少见。大多数I期精原细胞瘤患者(约85%)通过根治性睾丸切除术治愈。鉴于这种现象相对罕见,且完成监测的患者通常不进行常规肿瘤学检查和影像学检查,晚期复发的检测具有挑战性。虽然对于精原细胞瘤晚期复发的患者存在许多治疗选择,但手术通常是主要治疗方法,因为这些肿瘤通常被认为对化疗更具抗性。
在本文中,我们描述了一名早期纯精原细胞瘤患者的治疗情况,该患者在二十年后被发现复发。我们不仅回顾了侧重于临床因素和生物学的文献,还特别回顾了纯精原细胞瘤和前列腺晚期复发的治疗方法。
针对这一临床实体的数据和治疗建议匮乏,强调亚专业专家咨询和患者教育的多学科方法势在必行。