Evidence-based pragmatic guidelines for the follow-up of testicular cancer: optimising the detection of relapse.

Evidence-based pragmatic guidelines for the follow-up of testicular cancer: optimising the detection of relapse.
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DOI:
10.1038/sj.bjc.6604280
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发表时间:
2008-06-17
影响因子:
8.8
通讯作者:
Huddart, R. A.
Huddart, R. A.
中科院分区:
医学1区
文献类型:
--
作者:
van As, N. J.;Gilbert, D. C.;Money-Kyrle, J.;Bloomfield, D.;Beesley, S.;Dearnaley, D. P.;Horwich, A.;Huddart, R. A.

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睾丸生殖细胞肿瘤(tgct)是15至40岁男性癌症的最常见原因,总体而言,大多数患者应该有望治愈。欧洲生殖细胞癌共识小组为精原细胞瘤和非精原细胞瘤生殖细胞肿瘤的初步治疗提供了明确的指导方针。然而,对于如何在初次治疗后最好地跟踪患者,国际上尚无共识。这必须在不造成进一步伤害的情况下及时可靠地识别复发。随访的标准化将导致优化个体患者的风险-收益比,同时确保资源的经济利用。我们已经确定了治疗不同阶段精原细胞瘤和非精原细胞瘤的七种常见情况,并讨论了有关复发和随访的相关问题。我们回顾了现有的文献,并提出了我们全面的TGCT随访指南。我们的协议提供了一个实用的,易于访问的用户友好的基础,供其他中心使用或适应他们的需要。此外,这应该使未来的试验能够解决有关后续行动的具体问题,并提供有意义和有用的结果。
Testicular germ cell tumours (TGCTs) are the most common cause of cancer in men between the ages of 15 and 40 years, and, overall, the majority of patients should expect to be cured. The European Germ Cell Cancer Consensus Group has provided clear guidelines for the primary treatment of both seminoma and nonseminomatous germ cell tumours. There is, however, no international consensus on how best to follow patients after their initial management. This must promptly and reliably identify relapses without causing further harm. The standardising of follow-up would result in optimising risk-benefit ratios for individual patients, while ensuring economic use of resources. We have identified the seven common scenarios in managing seminomas and nonseminomas of the various stages and discuss the pertinent issues around relapse and follow-up. We review the available literature and present our comprehensive TGCT follow-up guidelines. Our protocols provide a pragmatic, easily accessible user-friendly basis for other centres to use or to adapt to suit their needs. Furthermore, this should enable future trials to address specific issues around follow-up giving meaningful and useful results.
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