SEOM‑GG clinical guidelines for the management of germ‑cell testicular cancer (2023)

• José Angel Arranz Arija ^[1] ; Xavier García del Muro ^[2] ; Raquel Luque Caro ^[3] ; María José Méndez Vidal ^[4] ; Begoña Pérez Valderrama ^[4] ; Jorge Aparicio ^[9] ; Miguel Ángel Climent Durán ^[5] ; Cristina Caballero Díaz ^[6] ; Ignacio Durán ^[7] ; Enrique González Billalabeitia ^[8]
  1. [1] Hospital General Universitario Gregorio Marañón

     Hospital General Universitario Gregorio Marañón

     Madrid, España

     
  2. [2] Hospital Duran i Reynals

     Hospital Duran i Reynals

     Barcelona, España

     
  3. [3] Hospital Universitario Virgen de las Nieves

     Hospital Universitario Virgen de las Nieves

     Granada, España

     
  4. [4] Hospital Universitario Reina Sofia

     Hospital Universitario Reina Sofia

     Cordoba, España

     
  5. [5] Instituto Valenciano de Oncologia

     Instituto Valenciano de Oncologia

     Valencia, España

     
  6. [6] Hospital General Universitario de Valencia

     Hospital General Universitario de Valencia

     Valencia, España

     
  7. [7] Hospital Universitario Marqués de Valdecilla

     Hospital Universitario Marqués de Valdecilla

     Santander, España

     
  8. [8] Hospital Universitario 12 de Octubre

     Hospital Universitario 12 de Octubre

     Madrid, España

     
  9. [9] Hospital Universitario I Politècnic La Fe, Valencia, Spain

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• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 26, Nº. 11, 2024, págs. 2783-2799
• Idioma: inglés
• Texto completo no disponible (Saber más ...)
• Resumen

  • Testicular germ cell tumors are the most common tumors in adolescent and young men. They are curable malignancies that should be treated with curative intent, minimizing acute and long-term side efects. Inguinal orchiectomy is the main diagnostic procedure, and is also curative for most localized tumors, while patients with unfavorable risk factors for recurrence, or those who are unable or unwilling to undergo close follow-up, may require adjuvant treatment. Patients with persistent markers after orchiectomy or advanced disease at diagnosis should be staged and classifed according to the IGCCCG prognostic classifcation. BEP is the most recommended chemotherapy, but other schedules such as EP or VIP may be used to avoid bleomycin in some patients. Eforts should be made to avoid unnecessary delays and dose reductions wherever possible. Insufcient marker decline after each cycle is associated with poor prognosis. Management of residual masses after chemotherapy difers between patients with seminoma and non-seminoma tumors. Patients at high risk of relapse, those with refractory tumors, or those who relapse after chemotherapy should be managed by multidisciplinary teams in experienced centers. Salvage treatment for these patients includes conventional-dose chemotherapy (TIP) and/or high-dose chemotherapy, although the best regimen and strategy for each subgroup of patients is not yet well established. In late recurrences, early complete surgical resection should be performed when feasible. Given the high cure rate of TGCT, oncologists should work with patients to prevent and identify potential long-term side efects of the treatment. The above recommendations also apply to extragonadal retroperitoneal and mediastinal tumors.