Organerhaltende Hodentumortherapie

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• 作者：C. Breunig (1)
  Prof. M. Schrader (1)
  A.J. Schrader (1)
  F. Zengerling (1)
  
• 关键词：Hodentumor ; maligner ; Hodenteilresektion ; Literaturrecherche ; Lebensqualit盲t ; Vorl盲uferl盲sion ; Malignant testicular cancer ; Partial orchidectomy ; Literature search ; Quality of life ; Precancerous conditions
• 刊名：Der Urologe A
• 出版年：2014
• 出版时间：September 2014
• 年：2014
• 卷：53
• 期：9
• 页码：1302-1309
• 全文大小：306 KB
• 参考文献：1. Huyghe E, Matsuda T, Thonneau P (2003) Increasing incidence of testicular cancer worldwide: a review. J Urol 170(1):5鈥?1 CrossRef
  2. Stoehr B, Zangerl F, Steiner E et al (2010) Routine scrotal ultrasonography during the follow-up of patients with testicular cancer leads to earlier detection of asynchronous tumours and a high rate of organ preservation. BJU Int 105(8):1118鈥?120 CrossRef
  3. Heidenreich A, Angerer-Shpilenya M (2012) Organ-preserving surgery for testicular tumours. BJU Int 109(3):474鈥?90 CrossRef
  4. Giannarini G, Dieckmann K-P, Albers P et al (2010) Organ-sparing surgery for adult testicular tumours: a systematic review of the literature. Eur Urol 57(5):780鈥?90 CrossRef
  5. Hallak J, Cocuzza M, Sarkis AS et al (2009) Organ-sparing microsurgical resection of incidental testicular tumors plus microdissection for sperm extraction and cryopreservation in azoospermic patients: surgical aspects and technical refinements. Urology 73(4):887鈥?92 CrossRef
  6. Heidenreich A, Weissbach L, H枚ltl W et al (2001) Organ sparing surgery for malignant germ cell tumor of the testis. J Urol 166(6):2161鈥?165 CrossRef
  7. Miller DC, Peron SE, Keck RW, Kropp KA (1990) Effects of hypothermia on testicular ischemia. J Urol 143(5):1046鈥?048
  8. Nord C, Bj酶ro T, Ellingsen D et al (2003) Gonadal hormones in long-term survivors 10 years after treatment for unilateral testicular cancer. Eur Urol 44(3):322鈥?28 CrossRef
  9. Heidenreich A, Albers P, Krege S (2006) Management of bilateral testicular germ cell cancer 鈥?experience of the German Testicular Cancer Study Group. Eur Urol (5 Suppl):97
  10. Steiner H, H枚ltl L, Maneschg C et al (2003) Frozen section analysis-guided organ-sparing approach in testicular tumors: technique, feasibility, and long-term results. Urology 62(3):508鈥?13 CrossRef
  11. Dieckmann KP, Skakkebaek NE (1999) Carcinoma in situ of the testis: review of biological and clinical features. Int J Cancer J Int Cancer 83(6):815鈥?22 CrossRef
  12. Classen J, Schmidberger H, Meisner C et al (2004) Para-aortic irradiation for stage I testicular seminoma: results of a prospective study in 675 patients. A trial of the German testicular cancer study group (GTCSG). Br J Cancer 90(12):2305鈥?311
  13. Chung PW, Jewett MA, Warde PR (2006) Testicular radiation for primary seminoma in a solitary testis. Can J Urol 13(1):2975鈥?977
  14. Kratzik C, Schatzl G, Lackner J, Marberger M (2006) Transcutaneous high-intensity focused ultrasonography can cure testicular cancer in solitary testis. Urology 67(6):1269鈥?273 CrossRef
  15. Reddy BV, Sivakanth A, Naveen Babu G et al (2014) Role of chemotherapy prior to orchiectomy in metastatic testicular cancer-is testis really a sanctuary site? Ecancermedicalscience 8:407
  16. Dieckmann K-P, Wilken S, Loy V et al (2013) Treatment of testicular intraepithelial neoplasia (intratubular germ cell neoplasia unspecified) with local radiotherapy or with platinum-based chemotherapy: a survey of the German Testicular Cancer Study Group. Ann Oncol 24(5):1332鈥?337 CrossRef
  
• 作者单位：C. Breunig (1)
  Prof. M. Schrader (1)
  A.J. Schrader (1)
  F. Zengerling (1)
  
  1. Klinik f眉r Urologie und Kinderurologie, Universit盲tsklinikum Ulm, Prittwitzstra脽e 43, 89075, Ulm, Deutschland
  
• ISSN：1433-0563

文摘

Background The therapy of malignant testicular neoplasms has always been characterized by a high degree of radicality. Thanks to a number of medical achievements the cure rate of testicular cancer has notably increased through the last decades. In the meanwhile the main focus is on reducing therapy load, scrutinizing radical orchiectomy as the only adequate therapy for the primary tumour. Objectives This article discusses the question, if and under which conditions an organ-sparing approach can be used appropriately in clinical practice. Materials and methods A selective literature search was performed in PubMed. Results A set of data suggest that endocrine and exocrine function of the testis can be preserved using an organ-sparing approach and many patients could benefit regarding their quality of life, e.g., preserving the ability to father a child at least temporarily and avoiding the need for hormone substitution. Different from kidney tumors, precancerous lesions (testicular intraepithelia neoplasia, TIN) can almost inevitably be found in the surrounding tissue of testicular tumors. This has to be considered when making a decision in favor of an organ-sparing approach, because radiation therapy on the affected testis has to be performed after tumor resection. Despite the absence of prospective data, organ-sparing surgical tumor resection can be recommended in carefully selected patients. Conclusion After careful selection of patients, particularly young men can profit from an organ-sparing therapy regimen. Therefore, organ preservation should always be considered in the surgical treatment of testicular masses.