Non-seminomatous germ cell testis tumors

Stephen D W Beck, Richard Foster

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

The optimal treatment for low stage disease is largely patient driven with surgery, surveillance and chemotherapy considered the primary treatment modalities. In low volume non-seminomatous germ cell cancer, (clinical stage A/B1) retroperitoneal lymph node dissection has maintained its therapeutic benefit while minimizing morbidity with the reduction of the surgical template from a full bilateral dissection to a unilateral nervesparring surgery. In the post chemotherapy population, patients with complete radiographic resolution of retroperitoneal disease are typically observed as the relapse rate in this population is ~ 5%. Residual masses after chemotherapy should be resected. A modified post chemotherapy dissection is adequate in carefully selected patients with low volume disease restricted to the primary landing zone of the affected testicle. A full bilateral RPLND remains standard template for larger volume disease. In chemorefractory disease, aggressive surgery provides a 5-year survival of 31% for patients with active cancer. Excluding chemo-naïve patients, late relapse disease is managed surgically with 50% being cured of disease. The vast majority (approximately 90 to 95%) of neoplasms of the testis are of germcell origin because these cells are mitotically very active and therefore most prone to developing DNA mutations (1). The supporting cells of the testis, Sertoli cell and Leydig cells, have low proliferative rates, and consequently tumors derived from these cells are unusual, comprising fewer than 4% of all testicular tumors (2). Germ cell tumors are composed of five basic cell types: seminoma, embryonal cell carcinoma, yolk sac tumor, choriocarcinoma, and teratoma. Classic seminoma is the most common tumor of the testis accounting for approximately 35% to 55% of all germ-cell neoplasms. The focus of this chapter is the management of non-seminomatous germ-cell tumors.

Original languageEnglish
Title of host publicationEssentials and Updates in Urologic Oncology (2 Volume Set)
PublisherNova Science Publishers, Inc.
Pages579-606
Number of pages28
ISBN (Print)9781620816493
StatePublished - 2012

Fingerprint

Testis
Tumors
Cells
Chemotherapy
Dissection
Germ Cell and Embryonal Neoplasms
Surgery
Drug Therapy
Seminoma
Testicular Neoplasms
Endodermal Sinus Tumor
Embryonal Carcinoma Stem Cells
Recurrence
Neoplasms
Choriocarcinoma
Leydig Cells
Sertoli Cells
Teratoma
Nonseminomatous germ cell tumor
Landing

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Beck, S. D. W., & Foster, R. (2012). Non-seminomatous germ cell testis tumors. In Essentials and Updates in Urologic Oncology (2 Volume Set) (pp. 579-606). Nova Science Publishers, Inc..

Non-seminomatous germ cell testis tumors. / Beck, Stephen D W; Foster, Richard.

Essentials and Updates in Urologic Oncology (2 Volume Set). Nova Science Publishers, Inc., 2012. p. 579-606.

Research output: Chapter in Book/Report/Conference proceedingChapter

Beck, SDW & Foster, R 2012, Non-seminomatous germ cell testis tumors. in Essentials and Updates in Urologic Oncology (2 Volume Set). Nova Science Publishers, Inc., pp. 579-606.
Beck SDW, Foster R. Non-seminomatous germ cell testis tumors. In Essentials and Updates in Urologic Oncology (2 Volume Set). Nova Science Publishers, Inc. 2012. p. 579-606
Beck, Stephen D W ; Foster, Richard. / Non-seminomatous germ cell testis tumors. Essentials and Updates in Urologic Oncology (2 Volume Set). Nova Science Publishers, Inc., 2012. pp. 579-606
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