Open AccessCurrent management and management controversies in early- and intermediate-stage of nonseminoma germ cell tumors
Author(s) -
Salim Cheriyan,
Marilin Nicholson,
Ahmet Aydın,
Mounsif Azizi,
Charles C. Peyton,
Wade J. Sexton,
Scott M. Gilbert
Publication year - 2020
Publication title -
translational andrology and urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.721
H-Index - 27
eISSN - 2223-4691
pISSN - 2223-4683
DOI - 10.21037/tau.2019.05.14
Subject(s) - retroperitoneal lymph node dissection , medicine , stage (stratigraphy) , oncology , chemotherapy , germ cell tumors , testicular cancer , dissection (medical) , disease , surgery , paleontology , biology
Early stage nonseminomatous germ cell tumor (NSGCT) remains a treatable disease, with stage I cancer specific survival exceeding 95%. Using a risk-adapted approach; active surveillance (AS), adjuvant chemotherapy, and retroperitoneal lymph node dissection (RPLND) all options for treatment; with surveillance being increasingly used. With persistently elevated markers (stage IS), chemotherapy remains the hallmark of treatment. Management of stage II NSGCT varies based on status of tumor markers. With negative markers, both induction chemotherapy and upfront RPLND remain options. Management of a residual mass <1 cm after chemotherapy remains controversial, with AS and nerve-sparing RPLND considered options. The development of miR-371a-3p microRNA shows promise a novel biomarker for testicular cancer (GCT). Despite controversies in management, cures for NSGCT are achievable in 95-99% of patients.