Post-orchiectomy treatment for clinical stage 1 non-seminomatous germ cell tumors (NSGCT) remains highly debated.
Cure rates for testicular germ cell tumors exceed 99 % in early stage disease despite the lack of consensus regarding post-orchiectomy treatment. The controversy relates to the challenge of identifying those patients with clinical stage 1 (CS 1) NSGCT who are most likely to benefit from adjuvant therapies. Established post-orchiectomy treatment options for CS 1 NSGCT include observation, adjuvant chemotherapy and retroperitoneal lymph node dissection. Effective salvage therapies allow for cure rates which approach 100 % for each of these options. The data suggest that low-risk CS 1 NSGCT can be treated with surveillance and consideration for all three options is necessary for high-risk patients. The data show that high-risk patients are those whose disease pathology demonstrates lymphovascular invasion. The decision regarding post-orchiectomy treatment should be based on a discussion with the patient and the specific expertise of the treating institution.
Written by:
Coleman S, Stephenson A. Are you the author?
Glickman Urological and Kidney Institute, Cleveland Clinic, 9500 Euclid Avenue, Q10-1, Cleveland, OH, 44195-0001, USA.
Reference: Curr Urol Rep. 2013 Jul 31. Epub ahead of print.
doi: 10.1007/s11934-013-0362-5
PubMed Abstract
PMID: 23901036
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