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睾丸生殖细胞肿瘤的肿瘤学随访策略:一项叙述性综述

Oncological Follow-up Strategies for Testicular Germ Cell Tumours: A Narrative Review.

作者信息

Kaufmann Ernest, Antonelli Luca, Albers Peter, Cary Clint, Gillessen Sommer Silke, Heidenreich Axel, Oing Christoph, Oldenburg Jan, Pierorazio Phillip Martin, Stephenson Andrew J, Fankhauser Christian Daniel

机构信息

University of Zurich, Zurich, Switzerland.

Department of Urology, Luzerner Kantonssspital, Lucerne, Switzerland.

出版信息

Eur Urol Open Sci. 2022 Sep 7;44:142-149. doi: 10.1016/j.euros.2022.08.014. eCollection 2022 Oct.

Abstract

CONTEXT

The aim of this review is to describe the proportion of testicular germ cell tumours (tGCTs) with recurrence, and the timing and anatomical sites of relapse across different disease stages and after different treatment options. We summarise published follow-up protocols and discuss current and future developments to personalise follow-up for patients with tGCT.

EVIDENCE ACQUISITION

A systematic literature search was conducted and current guidelines and selected institutional follow-up protocols were reviewed.

EVIDENCE SYNTHESIS

Of 302 publications, we screened 68 full texts and included 29 studies; 22 of these were retrospective and seven were prospective in nature, contributing data for 20 570 patients. The number of patients included per study ranged from 119 to 2483. We compared the guideline follow-up protocols of the European Society for Medical Oncology, European Association of Urology, National Comprehensive Cancer Network, and American Urological Association, as well as institutional follow-up protocols. The protocols differed in terms of the number, time points, and type of follow-up investigations.

CONCLUSIONS

Future research should assess how tGCT can be followed to ensure high adherence, define the role of miR-371a-3p microRNA during follow-up, and develop follow-up protocols after curative treatment in the metastatic setting.

PATIENT SUMMARY

In this review of follow-up protocols for men with testis cancer, we observed different recommendations and discuss future research areas to improve follow-up for these patients.

摘要

背景

本综述的目的是描述睾丸生殖细胞肿瘤(tGCT)复发的比例,以及不同疾病阶段和不同治疗方案后复发的时间和解剖部位。我们总结已发表的随访方案,并讨论当前和未来的发展方向,以便为tGCT患者制定个性化的随访方案。

证据获取

进行了系统的文献检索,并对当前指南和选定机构的随访方案进行了综述。

证据综合

在302篇出版物中,我们筛选了68篇全文并纳入了29项研究;其中22项为回顾性研究,7项为前瞻性研究,共纳入20570例患者的数据。每项研究纳入的患者数量从119例到2483例不等。我们比较了欧洲医学肿瘤学会、欧洲泌尿外科学会、美国国立综合癌症网络和美国泌尿外科学会的指南随访方案,以及机构随访方案。这些方案在随访调查的数量、时间点和类型方面存在差异。

结论

未来的研究应评估如何对tGCT进行随访以确保高依从性,确定miR-371a-3p微小RNA在随访中的作用,并制定转移性疾病根治性治疗后的随访方案。

患者总结

在本次对睾丸癌男性患者随访方案的综述中,我们观察到了不同的建议,并讨论了未来的研究领域,以改善对这些患者的随访。

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本文引用的文献

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Safety of Minimizing Intensity of Follow-up on Active Surveillance for Clinical Stage I Testicular Germ Cell Tumors.
Eur Urol Open Sci. 2022 Apr 27;40:46-53. doi: 10.1016/j.euros.2022.03.010. eCollection 2022 Jun.
2
Circulating MicroRNAs for Detection of Germ Cell Tumours: A Narrative Review.
Eur Urol Focus. 2022 May;8(3):660-662. doi: 10.1016/j.euf.2022.04.008. Epub 2022 May 7.
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Detection of recurrences using serum miR-371a-3p during active surveillance in men with stage I testicular germ cell tumours.
Br J Cancer. 2022 May;126(8):1140-1144. doi: 10.1038/s41416-021-01643-z. Epub 2021 Dec 15.
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Survival and New Prognosticators in Metastatic Seminoma: Results From the IGCCCG-Update Consortium.
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Utility of Serum miR-371a-3p in Predicting Relapse on Surveillance in Patients with Clinical Stage I Testicular Germ Cell Cancer.
Eur Urol Oncol. 2021 Jun;4(3):483-491. doi: 10.1016/j.euo.2020.11.004. Epub 2020 Dec 4.
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Ten years of experience with MRI follow-up of testicular cancer stage I: a retrospective study and an MRI protocol with DWI.
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