Conservative management of testicular germ-cell tumors.

Conservative management of testicular germ-cell tumors. Research Abstract Details 

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Conservative management of testicular germ-cell tumors. Abstract Text:

Tim Oliver,Tim Oliver,

Cure rates of germ-cell cancer have been greater than 95% for the last decade; therefore, over the past few years there has been a greater focus on 'conservative' approaches to treatment. The increased incidence of late non-germ-cell cancers in the era of radiotherapy and the incidence of subclinical testicular deficiency and metabolic syndrome in cured patients have accelerated this trend. Taking account of the increase in cure rates of primary chemotherapy failures from 5% to 60% with intensification of chemotherapy and surgery, this Review focuses on three areas: lessons from the initial failed trials of less-intensive treatment (i.e. bleomycin withdrawal and carboplatin substitution) that emphasised the need for improved salvage therapy; successes of reducing treatment of patients with metastases classed as good-risk from four cycles(20 days) to three cycles(9 days) and using 1 day carboplatin instead of 21 day radiotherapy as adjuvant for stage 1 seminoma; and the unexpected finding at 5 years of a 72% reduction of contralateral second germ-cell cancer. This finding provides the stimulus for the next generation of conservative trials using organ preservation, aiming to reduce occurrence of metabolic syndrome and using new radiological and minimal surgery techniques to accelerate the assessment of less toxic drugs and new approaches for combined medial and surgical treatment.

Conservative management of testicular germ-cell tumors. Publishing Authors By Initials

T Oliver,T Oliver,

For similar neoplasms: neoplasms by site: endocrine gland neoplasms: testicular neoplasms research abstracts see: neoplasms: neoplasms by site: endocrine gland neoplasms: testicular neoplasms research

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Conservative management of testicular germ-cell tumors. Journal Published:

PUBLICATION TYPE: Review

Journal: Nature clinical practice. Urology

VOLUME: 4

Page Numbers: 550-60

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ISSN: 1743-4289

DAY: 28

MONTH: Oct

YEAR: 2007

Conservative management of testicular germ-cell tumors. Information

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LANGUAGE: eng

NlmUniqueID: 101226508

Conservative management of testicular germ-cell tumors. Keywords Mesh Terms:

KEYWORDS: Testicular Neoplasms

MESH TERMS: therapy

Chemical & Substance for Abstract: Conservative management of testicular germ-cell tumors. Information

Substance Name: Antineoplastic Agents

Registry Number: 0

Grant and Affiliation Information for Conservative management of testicular germ-cell tumors.

AFFILIATION: Institute of Cancer, St Bartholomew's and The Royal London Hospital School of Medicine and Dentistry, London, UK. r.t.oliver@qmul.ac.uk

Country: United States

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MEDLINETA: Nat Clin Pract Urol

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