Universität zu Köln

Heidenreich, A., Paffenholz, P., Haidl, F. and Pfister, D. (2017). At what time surgical Removal of metastases is indicated for testicular Germ Cell Tumors and is there a scientific Basis for this? Urologe, 56 (5). S. 627 - 637. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1433-0563

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Abstract

Surgical resection of metastases represents an integral part of curative management in patients with testicular germ cell tumors (GCT). Primary nerve-sparing retroperitoneal lymph node dissection (nsRPLND) for low volume metastases in clinical stages I-IIB has to be differentiated from the more complex and more extensive postchemotherapeutic procedures. In Europe, primary nerve-sparing retroperitoneal lymph node dissection (nsRPLND) for clinical stage I nonseminomatous GCT (NSGCT) plays a subordinate. In clinical stage IIA/B, nsRPLND is indicated for patients with marker-negative metastases in whom cure rates of about 65% can be achieved with surgery alone. For clinical stage IIA/B seminomas, nsRPLND represents an individual, still experimental procedure with high cure rates. Postchemotherapy residual tumor resection (pRTR) for advanced seminomas is only indicated in the context of a FDG-PET/CT-positive residual mass > 3 cm in diameter. For NSGCT, pRTR is indicated in patients with residual masses > 1 cm and negative or plateauing tumor markers to resect persisting teratoma or vital cancer. Complete resection of all masses including resection of adjacent vascular, visceral or skeletal metastases is mandatory to achieving the highest cure rate possible. Due to the complexity and the lower rate of significant morbidity and mortality, these procedures should be done at tertiary referral centers.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Heidenreich, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Paffenholz, P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Haidl, F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Pfister, D. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-232604
DOI:	10.1007/s00120-017-0385-5
Journal or Publication Title:	Urologe
Volume:	56
Number:	5
Page Range:	S. 627 - 637
Date:	2017
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1433-0563
Language:	German
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language LYMPH-NODE DISSECTION; GROWING TERATOMA SYNDROME; CANCER STUDY-GROUP; POSTCHEMOTHERAPY RESIDUAL MASSES; SPARING RETROPERITONEAL LYMPHADENECTOMY; UNIVERSITY EXPERIENCE 1965-1989; NONSEMINOMATOUS TESTIS CANCER; PROSPECTIVE MULTICENTER TRIAL; HIGH-DOSE CHEMOTHERAPY; TERM-FOLLOW-UP Multiple languages Urology & Nephrology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/23260