Leibundgut U, Biedermann C, Landmann C, Obrecht J P
Schweiz Med Wochenschr. 1984 Jun 9;114(23):820-6.
In the past few years the therapeutic options for non-seminomatous germ-cell tumors of the testis have evolved rapidly. Until recently it was usual practice with patients in clinical stage I to perform lymphadenectomy or retroperitoneal radiotherapy after orchidectomy. However, for 60-80% of these patients this therapy was not necessary, since they were already cured by orchidectomy alone. With the improvement of clinical staging and the success of modern chemotherapy, it seems to be possible to follow up stage I patients clinically. The various aspects which justify this "wait-and-see" strategy are discussed. Further, the question is discussed whether all patients in clinical stage I may be treated in this way, or whether specific groups at severe risk of metastatic disease at the time of orchidectomy should be excluded.
在过去几年中，睾丸非精原细胞瘤的治疗选择迅速发展。直到最近，临床I期患者的常规做法是在睾丸切除术后进行淋巴结清扫或腹膜后放疗。然而，这些患者中有60%-80%并不需要这种治疗，因为他们仅通过睾丸切除术就已治愈。随着临床分期的改善和现代化疗的成功，对I期患者进行临床随访似乎成为可能。本文讨论了支持这种“观察等待”策略的各个方面。此外，还讨论了是否所有临床I期患者都可以采用这种方式治疗，或者在睾丸切除时是否应排除有严重转移疾病风险的特定群体。
