Seminars in urologic oncology最新文献

Controversies in the management of testicular seminoma. 睾丸精原细胞瘤治疗的争议。

Seminars in urologic oncology Pub Date : 2002-11-01 DOI: 10.1053/suro.2002.36979

Neil Fleshner, Padraig Warde

{"title":"Controversies in the management of testicular seminoma.","authors":"Neil Fleshner, Padraig Warde","doi":"10.1053/suro.2002.36979","DOIUrl":"https://doi.org/10.1053/suro.2002.36979","url":null,"abstract":"Tremendous progress has been made in the treatment of testicular seminoma over the past 25 years. The advent of curative cytotoxic chemotherapy, even for patients with advanced metastatic disease, has led to a paradigm shift toward minimizing additional oncologic therapies and their potential side effects. Despite these advances, controversial issues still exist in managing patients with this disease. Patients with stage I disease can now be managed successfully with close surveillance or postoperative radiotherapy (RT). Although deemed safe, considerable debate persists about surveillance including issues of compliance, cost, and secondary effects of routine RT. Aside from RT, patients with stage I disease also can be managed with one- or 2-dose single-agent carboplatin. Although this appears safe and efficacious, an ongoing randomized study is underway to compare its effectiveness with that of RT. Residual mass after chemotherapy for seminoma is not uncommon and therapeutic options include observation, RT, or retroperitoneal lymphadenectomy. Although most agree that patients with small (<3 cm) or ill-defined masses can be observed, debate persists as to the optimal management of patients with well-defined masses greater than 3 cm. For many years, patients with bulky retroperitoneal disease (>5 cm) were treated with up-front radiotherapy and chemotherapy at relapse. The high failure rate outside the treatment field has now changed this paradigm to one of up-front chemotherapy.","PeriodicalId":79436,"journal":{"name":"Seminars in urologic oncology","volume":"20 4","pages":"227-33"},"PeriodicalIF":0.0,"publicationDate":"2002-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22161730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 19

Poor prognosis germ-cell tumors: An unresolved challenge. 不良预后生殖细胞肿瘤:一个未解决的挑战。

Seminars in urologic oncology Pub Date : 2002-11-01 DOI: 10.1053/suro.2002.36978

Guy C Toner, Mark Frydenberg

引用次数: 2

Contralateral testicular biopsy procedure in patients with unilateral testis cancer: is it indicated? 单侧睾丸癌患者的对侧睾丸活检手术:是否有指征?

Seminars in urologic oncology Pub Date : 2002-11-01 DOI: 10.1053/suro.2002.36980

Axel Heidenreich, Judd W Moul

{"title":"Contralateral testicular biopsy procedure in patients with unilateral testis cancer: is it indicated?","authors":"Axel Heidenreich, Judd W Moul","doi":"10.1053/suro.2002.36980","DOIUrl":"https://doi.org/10.1053/suro.2002.36980","url":null,"abstract":"About 5% of all patients with unilateral testis cancer harbor testicular intraepithelial neoplasia (TIN) in their contralateral testicle, which will progress into an invasive germ-cell tumor over time. Accurate diagnosis of TIN by a random surgical testis biopsy examination and effective therapy by local radiation has led to the concept of a contralateral screening biopsy procedure in all testis cancer patients. Screening and preventive treatment, however, only are indicated if (1) therapeutic outcome of the screened population is improved and (2) physiologic function of the affected organ might be maintained. Based on a critical review of the literature, some drawbacks of this policy have to be considered and the routine indication for contralateral testis biopsy procedure has to be questioned: (1) all TIN-negative patients still have to undergo meticulous follow-up evaluation for metachronous testis cancer owing to a false-negative biopsy diagnosis rate of 0.3%; (2) testis biopsy procedure is associated with a 15% to 20% complication rate, which might a negative impact on endocrine and exocrine testicular function; (3) local radiation of TIN results in irreversible infertility owing to eradication of spermatogenesis; (4) local radiation of TIN results in an impairment of endocrine Leydig cell function in 25% of patients; (5) therapeutic outcome and prognosis will not be improved in irradiated patients as compared with patients on surveillance; (6) local tumor resection for the management of metachronous testicular cancer represents an effective and viable option. The current literature does not support the strategy to perform contralateral testis biopsy procedures in all patients with unilateral testicular germ-cell tumors. Testis biopsy procedures might, however, be offered to high-risk (34%) patients for contralateral TIN with a testicular volume less than 12 mL, a history of cryptorchidism, and an age less than 30 years.","PeriodicalId":79436,"journal":{"name":"Seminars in urologic oncology","volume":"20 4","pages":"234-8"},"PeriodicalIF":0.0,"publicationDate":"2002-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22161731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 35

Management of stage I nonseminomatous germ-cell tumors. I期非半细胞性生殖细胞肿瘤的治疗。

Seminars in urologic oncology Pub Date : 2002-11-01 DOI: 10.1053/suro.2002.36976

John Thomas, Michael Aleman, Robert Dreicer, Eric A Klein

引用次数: 6

The role of adjunctive postchemotherapy surgery for nonseminomatous germ-cell tumors: current concepts and controversies. 非精原性生殖细胞肿瘤化疗后辅助手术的作用:目前的概念和争议。

Seminars in urologic oncology Pub Date : 2002-11-01 DOI: 10.1053/suro.2002.36977

Joel Sheinfeld

{"title":"The role of adjunctive postchemotherapy surgery for nonseminomatous germ-cell tumors: current concepts and controversies.","authors":"Joel Sheinfeld","doi":"10.1053/suro.2002.36977","DOIUrl":"https://doi.org/10.1053/suro.2002.36977","url":null,"abstract":"Adjunctive surgical resection of residual disease after chemotherapy is a critical part of the comprehensive management of patients with advanced nonseminomatous germ-cell tumor (NSGCT). Surgical resection is indicated in the presence of residual radiographic abnormalities and normal serum tumor markers. Necrosis, teratoma, and viable carcinoma can be found at any resected site. After induction chemotherapy, necrosis comprises approximately 50% of histologic findings, teratoma 40%, and viable GCT the remaining 10%. A number of investigators have attempted to predict the presence of necrosis in an effort to obviate surgery. A number of variables predictive of necrosis have been identified and tested prospectively, including: degree of tumor shrinkage, size of pre- and posttreatment mass(es), prechemotherapy markers, and teratomatous components in the orchiectomy specimen. However, the risk for a false-negative prediction remains approximately 20%. The most rigorous approach remains a retroperitoneal lymph node dissection (RPLND). Furthermore, the histologic discordance between different sites ranges from 29% to 46%; thus, all sites of residual disease should be resected. The patient's prognosis is influenced by: (1) completeness of resection, and (2) biology of the tumor (histology of residual mass(es), marker status at the time of RPLND, and prior burden of therapy). Surgical boundaries and completeness of dissection should not be compromised in an attempt to preserve ejaculation.","PeriodicalId":79436,"journal":{"name":"Seminars in urologic oncology","volume":"20 4","pages":"262-71"},"PeriodicalIF":0.0,"publicationDate":"2002-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22161735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 52

Adjuvant chemotherapy for stage II nonseminomatous germ-cell tumors. II期非精原瘤性生殖细胞肿瘤的辅助化疗。

Seminars in urologic oncology Pub Date : 2002-11-01 DOI: 10.1053/suro.2002.36975

G Varuni Kondagunta, Robert J Motzer

引用次数: 4

Chemotherapy for good-risk germ-cell tumors. 高危生殖细胞肿瘤的化疗。

Seminars in urologic oncology Pub Date : 2002-11-01 DOI: 10.1053/suro.2002.37208

Charles J Ryan, Dean F Bajorin

引用次数: 3

Imaging of the urinary tract using multidetector computed tomography urography. 多检测器计算机断层尿路成像。

Seminars in urologic oncology Pub Date : 2002-08-01 DOI: 10.1053/suro.2002.35331

Elaine M Caoili

引用次数: 15

Hormonal therapy of prostate cancer. 前列腺癌的激素治疗。

Seminars in urologic oncology Pub Date : 2002-08-01 DOI: 10.1053/SURO.2002.35051

F. Debruyne

引用次数: 40

Neoadjuvant strategies for prostate cancer prior to radical prostatectomy. 根治性前列腺切除术前前列腺癌的新辅助治疗策略。

Seminars in urologic oncology Pub Date : 2002-08-01 DOI: 10.1053/SURO.2002.35055

M. Meng, G. Grossfeld, P. Carroll, E. Small

引用次数: 6