Year: 2006
Type: article
Abstract: Despite its relative rarity, GCT in the adult male serves as a model of curability. The appropriate use of surgery, radiation, chemotherapy, and multimodality approaches has been studied in randomized trials that have successfully established many treatment paradigms. de Wit and Fizazi 4 review the controversies and treatment options in the optimal management of clinical stage I seminoma and nonseminomatous GCTs, and provide a detailed overview of the clinical trial results with a discussion of the risks and benefits of surveillance, surgery, radiation therapy (for seminoma), and adjuvant chemotherapy. In the treatment of metastatic disease, the International Germ Cell Cancer Collaborative Group’s risk algorithm established international agreement on the clinical features that constitute good, intermediate, and poor prognosis, 5 each of which has established standards of care. Kondagunta and Motzer 6 update the standards of care for the treatment of patients with both previously untreated and relapsed disease and address controversies such as the use of bleomycin in good-risk disease, the use of high-dose chemotherapy with stem-cell rescue, and postchemotherapy management of advanced seminoma. Oldenberg et al 7 review the risk factors associated with, and the clinical management of, late relapse, defined as disease recurrence 2 or more years after primary therapy. Once thought to be an exceedingly rare event, recent reports suggest that late relapses may be more common. An improved understanding of the genetic molecular events that are observed in GCT has emerged in the last two decades, beginning with the observation that an isochromosome of 12p (i[12p]) was frequently observed in GCT. Houldsworth et al provide an overview of the pathobiology of adult GCT, the role of 12p genes implicated in malignant transformation of germ cells, and insights into chemotherapy sensitivity and resistance. 8
Source: Journal of Clinical Oncology
Institution: Memorial Sloan Kettering Cancer Center
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2124608637