Universität zu Köln

Pierorazio, Phillip Martin, Albers, Peter ORCID: 0000-0002-1747-9615, Black, Peter C., Tandstad, Torgrim, Heidenreich, Axel, Nicolai, Nicola ORCID: 0000-0002-5718-2699 and Nichols, Craig (2018). Non-risk-adapted Surveillance for Stage I Testicular Cancer: Critical Review and Summary. Eur. Urol., 73 (6). S. 899 - 908. AMSTERDAM: ELSEVIER. ISSN 1873-7560

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Abstract

Context: Cancer-specific survival for men with clinical stage I testicular cancer (CSITC) is uniformly excellent. Non-risk-adapted active surveillance (NRAS) is a management strategy for CSITC to minimize overtreatment and avoid possible long-term side effects of adjuvant therapy. Objective: To review the evidence regarding oncologic outcomes for men with CSITC undergoing NRAS and discuss ongoing controversies in the management of CSITC. Evidence acquisition: MEDLINE/PubMed, Embase, and the Cochrane Central Register of Controlled Trials were searched from January 1, 1987 through January 1, 2017. Evidence synthesis: A total of 68 studies were included in the critical review. The rationale for NRAS, oncologic outcomes, surveillance protocols, and comparative efficacy of risk-adjusted active surveillance (AS) were reported with strength of evidence and risk of bias evaluated. Cancer-specific survival approaches 100% for men with CSITC undergoing NRAS. Active treatment is limited to 20-30% of patients who will recur; these patients will require salvage chemotherapy and possible retroperitoneal lymph node dissection. Existing AS protocols include imaging and laboratory evaluations that are initially intensive but less frequent with increasing follow-up. Conclusions: NRAS is an attractive management option for men with CSITC, which maintains outstanding long-term cancer cure while sparing most patients treatment by avoiding prophylactic chemotherapy, radiation, or surgery. management strategy. (C) 2018 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Pierorazio, Phillip Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Albers, Peter UNSPECIFIED orcid.org/0000-0002-1747-9615 UNSPECIFIED Black, Peter C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Tandstad, Torgrim UNSPECIFIED UNSPECIFIED UNSPECIFIED Heidenreich, Axel UNSPECIFIED UNSPECIFIED UNSPECIFIED Nicolai, Nicola UNSPECIFIED orcid.org/0000-0002-5718-2699 UNSPECIFIED Nichols, Craig UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-183323
DOI:	10.1016/j.eururo.2017.12.030
Journal or Publication Title:	Eur. Urol.
Volume:	73
Number:	6
Page Range:	S. 899 - 908
Date:	2018
Publisher:	ELSEVIER
Place of Publication:	AMSTERDAM
ISSN:	1873-7560
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language GERM-CELL TUMORS; LYMPH-NODE DISSECTION; TERM-FOLLOW-UP; LONG-TERM; ADJUVANT CARBOPLATIN; TESTIS CANCER; PROGNOSTIC-FACTORS; POSTORCHIECTOMY SURVEILLANCE; ACTIVE SURVEILLANCE; SEMINOMA Multiple languages Urology & Nephrology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/18332