Pfister David, Rieger Constantin, Seelemeyer Felix, Heidenreich Axel
Klinik für Urologie, Uro-Onkologie, spezielle urologische und Roboter-assistierte Chirurgie, Uniklinik Köln, Kerpenerstr. 62, 50937, Köln, Deutschland.
Klinik für Urologie, Medizinische Universität Wien, Wien, Österreich.
Urologie. 2024 Dec;63(12):1285-1293. doi: 10.1007/s00120-024-02446-9. Epub 2024 Oct 24.
Germ cell neoplasms of the testis are rare solid tumors predominantly in young men. Seminomas are slightly more frequent than nonseminomatous germ cell tumors. A special feature of seminomas is that they are sensitive to radiation, so that this represents an option in tumor stages with few metastases; however, the guideline recommendation is cautious due to the increased risk of secondary malignancies. In nonmetastasized tumor stages active surveillance is the primary approach to avoid overtreatment of patients. This is also the reason for primary nerve-sparing retroperitoneal lymph node dissection in cases of a low metastasis load. This concept has already been implemented in the American Urological Association (AUA) and National Comprehensive Cancer Network (NCCN) guidelines, whereas in the European Association of Urology (EAU) guidelines it is still considered to be an individual approach.
睾丸生殖细胞肿瘤是罕见的实体瘤,主要发生于年轻男性。精原细胞瘤比非精原细胞性生殖细胞肿瘤略为常见。精原细胞瘤的一个特点是对放疗敏感,因此在转移灶较少的肿瘤分期中,放疗是一种选择;然而,由于继发性恶性肿瘤风险增加,指南建议较为谨慎。在非转移性肿瘤分期中,主动监测是避免过度治疗患者的主要方法。这也是在转移负荷较低的情况下进行保留神经的腹膜后淋巴结清扫术的原因。这一概念已在美国泌尿外科学会(AUA)和美国国立综合癌症网络(NCCN)指南中实施,而在欧洲泌尿外科学会(EAU)指南中,它仍被视为一种个体化方法。