The management of testis cancer

Surgery (Oxford, Oxfordshire) Pub Date : 2025-10-01 DOI:10.1016/j.mpsur.2025.07.018

Lara Hemsworth, Narin Suleyman

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Abstract

Testicular cancers diagnosed in adults are primarily germ cell tumours (GCT, 95%) with a smaller proportion being sex cord-stromal tumours (5%). GCTs are a histologically diverse spectrum of tumours, broadly categorized to seminoma and non-seminomatous germ cell tumour (NSGCT). Treatment is based on histological subtype and stage and involves radical inguinal orchidectomy alongside surveillance, chemotherapy, radiotherapy or retroperitoneal lymph node dissection. Serum tumour markers including β-human chorionic gonadotrophin and α-fetoprotein and lactate dehydrogenase have a unique role in staging, prognosis, treatment planning and surveillance after initial orchidectomy. In this review we outline staging and prognostic classifications used in testicular GCT and the surgical and non-surgical treatment of testicular GCT as advised by the US National Comprehensive Cancer Network (NCCN), the European Association of Urology (EAU) and the consensus recommendations from The European Society for Medical Oncology (ESMO). Additional considerations related to GCT treatment are also outlined including fertility preservation, chemotherapy and radiotherapy toxicity and late secondary malignancy.

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睾丸癌的治疗

成人诊断的睾丸癌主要是生殖细胞瘤（GCT, 95%），性索间质瘤的比例较小（5%）。生殖细胞瘤是一种组织学上多样化的肿瘤，大致分为精原细胞瘤和非精原细胞生殖细胞瘤（NSGCT）。治疗基于组织学亚型和分期，包括根治性腹股沟睾丸切除术、化疗、放疗或腹膜后淋巴结清扫。血清肿瘤标志物包括β-人绒毛膜促性腺激素、α-胎蛋白和乳酸脱氢酶在初次睾丸切除术后的分期、预后、治疗计划和监测中具有独特的作用。在这篇综述中，我们概述了睾丸GCT的分期和预后分类，以及美国国家综合癌症网络（NCCN）、欧洲泌尿外科协会（EAU）和欧洲肿瘤医学学会（ESMO）建议的睾丸GCT的手术和非手术治疗。与GCT治疗相关的其他考虑因素还概述了包括生育能力保存，化疗和放疗毒性和晚期继发性恶性肿瘤。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgery (Oxford, Oxfordshire)

CiteScore

1.00

自引率

0.00%

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