Pizzocaro G, Salvioni R, Nicolai N
Istituto Nazionale per lo Studio e la Cura dei Tumori, Milano, Italia.
Eur Urol. 1995;28(4):267-72. doi: 10.1159/000475066.
To find out up-to-date indications to adjuvant therapy in low-stage germ cell tumors (GCT) of the testis.
The authors reviewed the material of the National Cancer Institute in Milan and the major international papers on adjuvant therapies of GCT of the testis.
Moderate dose irradiation of retroperitoneal nodes remains the standard therapy of stage I seminoma; mediastinal irradiation has been abandoned in stage II seminoma. Nerve-sparing retroperitoneal lymph node dissection and surveillance remain standard therapies for nonseminomatous stage I tumors; 2 adjuvant courses of cisplatin-based chemotherapy are under investigation in high-risk patients. Postoperative adjuvant chemotherapy is mandatory only in bulky pathological stage II non-seminoma, but it is advisable also in patients who cannot be carefully followed.
The cure rates of GCT of the testis can approach 100% in low stages and similar results can be achieved with different treatment modalities, but the maximum results can be obtained in specialized centers only.
明确睾丸低分期生殖细胞肿瘤（GCT）辅助治疗的最新适应证。
作者回顾了米兰国家癌症研究所的资料以及关于睾丸GCT辅助治疗的主要国际文献。
腹膜后淋巴结中等剂量照射仍是Ⅰ期精原细胞瘤的标准治疗方法；Ⅱ期精原细胞瘤已不再采用纵隔照射。保留神经的腹膜后淋巴结清扫术和观察等待仍是非精原细胞瘤Ⅰ期肿瘤的标准治疗方法；针对高危患者，正在研究基于顺铂的2个疗程辅助化疗。术后辅助化疗仅在病理分期为Ⅱ期且肿瘤体积较大的非精原细胞瘤中是必需的，但对于无法密切随访的患者也建议进行。
睾丸GCT在低分期时治愈率可接近100%，不同治疗方式可取得相似结果，但只有在专科中心才能获得最佳疗效。
