Urologic Oncology, Rush University, Chicago, Illinois.
Johns Hopkins Evidence-based Practice Center, Johns Hopkins University, Baltimore, Maryland.
J Urol. 2024 Jan;211(1):20-25. doi: 10.1097/JU.0000000000003694. Epub 2023 Sep 14.
The purpose of this American Urological Association (AUA) guideline amendment is to provide a useful reference on the effective evidence-based treatment strategies for early-stage testicular cancer.
METHODOLOGY/METHODS: The original methodology protocol included searches of PubMed®, Embase®, and the Cochrane Central Register of Controlled Trials (CENTRAL) from January 1980 through August 2018. The search strategy used medical subject heading (MeSH) terms and key words relevant to the diagnosis and treatment of early-stage testicular cancer. The searches conducted for the update presented herein utilized the same methodological protocol to capture literature published through March 2023. When sufficient evidence existed, the body of evidence was assigned a strength rating of A (high), B (moderate), or C (low) for support of Strong, Moderate, or Conditional Recommendations. In the absence of sufficient evidence, additional information is provided as Clinical Principles and Expert Opinions.
Updates were made to statements on imaging, seminoma management, non-seminoma management, surveillance for stage I testicular cancer, and additional survivorship. Further revisions were made to the methodology and reference sections as appropriate.
This guideline seeks to improve clinicians' ability to evaluate and treat patients with early-stage testicular cancer based on currently available evidence. Future studies will be essential to further support or refine these statements to improve patient care.
本美国泌尿外科学会 (AUA) 指南修订版旨在为早期睾丸癌的有效循证治疗策略提供有用的参考。
原始方法学方案包括 1980 年 1 月至 2018 年 8 月期间对 PubMed®、Embase®和 Cochrane 中央对照试验注册中心 (CENTRAL) 的搜索。搜索策略使用了与早期睾丸癌的诊断和治疗相关的医学主题词 (MeSH) 术语和关键词。本报告中呈现的更新搜索使用了相同的方法学方案,以捕获截至 2023 年 3 月发表的文献。当存在足够的证据时,证据体被分配了支持强、中或条件推荐的强度等级 A(高)、B(中)或 C(低)。在缺乏足够证据的情况下,提供了更多的临床原则和专家意见。
对影像学、精原细胞瘤管理、非精原细胞瘤管理、I 期睾丸癌的监测以及额外的生存问题的陈述进行了更新。还对方法学和参考部分进行了适当的修订。
本指南旨在提高临床医生根据现有证据评估和治疗早期睾丸癌患者的能力。未来的研究对于进一步支持或完善这些声明以改善患者护理至关重要。