Open AccessManagement of Germ Cell Tumours of the Testes in Adult Patients: German Clinical Practice Guideline, PART II – Recommendations for the Treatment of Advanced, Recurrent, and Refractory Disease and Extragonadal and Sex Cord/Stromal Tumours and for the Management of Follow-Up, Toxicity, Quality of Life, Palliative Care, and Supportive Therapy
Author(s) -
Sabine Kliesch,
Stefanie Schmidt,
Doris Wilborn,
Clemens Aigner,
Walter Albrecht,
Jens Bedke,
Matthias Beintker,
Dirk Beyersdorff,
Carsten Bokemeyer,
Jonas Busch,
Johannes Claßen,
Maike de Wit,
KlausPeter Dieckmann,
Thorsten Diemer,
Anette Dieing,
Matthias Göckel,
B. Göckel-Beining,
Oliver W. Hakenberg,
Axel Heidenreich,
Julia Heinzelbecker,
Kathleen Herkommer,
Thomas Hermanns,
Sascha Kaufmann,
Marko Kornmann,
Jörg Kotzerke,
Susanne Krege,
Glen Kristiansen,
Anja Lorch,
Arndt-Christian Müller,
Karin Oechsle,
Timur Ohloff,
Christoph Oing,
Ulrich Otto,
David Pfister,
Renate Pichler,
Heinrich Recken,
Oliver Rick,
Yvonne Rudolph,
Christian Ruf,
J Schirren,
Hans Ulrich Schmelz,
Heinz Schmidberger,
Mark Schrader,
Stefan Schweyer,
Stefanie Seeling,
Rainer Souchon,
Christian Winter,
C Wittekind,
Friedemann Zengerling,
DirkHenrik Zermann,
Roger Zillmann,
Peter Albers
Publication year - 2021
Publication title -
urologia internationalis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.771
H-Index - 53
eISSN - 1423-0399
pISSN - 0042-1138
DOI - 10.1159/000511245
Subject(s) - medicine , guideline , disease , consensus conference , gynecology , family medicine , pathology
Objectives: We developed the first German evidence- and consensus-based clinical guideline on diagnosis, treatment, and follow-up of germ cell tumours (GCT) of the testes in adult patients. We present the guideline content in 2 separate publications. The present second part summarizes the recommendations for the treatment of advanced disease stages and for the management of follow-up and late effects. Materials and Methods: An interdisciplinary panel of 42 experts including 1 patient representative developed the guideline content. Clinical recommendations and statements were based on scientific evidence and expert consensus. For this purpose, evidence tables for several review questions, which were based on systematic literature searches (last search in March 2018), were provided. Thirty-one experts, who were entitled to vote, rated the final clinical recommendations and statements. Results: Here we present the treatment recommendations separately for patients with metastatic seminoma and non-seminomatous GCT (stages IIA/B and IIC/III), for restaging and treatment of residual masses, and for relapsed and refractory disease stages. The recommendations also cover extragonadal and sex cord/stromal tumours, the management of follow-up and toxicity, quality-of-life aspects, palliative care, and supportive therapy. Conclusion: Physicians and other medical service providers who are involved in the diagnostics, treatment, and follow-up of GCT (all stages, outpatient and inpatient care as well as rehabilitation) are the users of the present guideline. The guideline also comprises quality indicators for measuring the implementation of the guideline recommendations in routine clinical care; these data will be presented in a future publication.