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1. Komatsubara S, Itoi T, Watanabe M, Kitamura Y, Koike T: [Treatment of metastatic seminoma by chemotherapy.: an experience]. Nihon Hinyokika Gakkai Zasshi; 2000 Oct-Nov;91(10-11):666-72
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  • [Title] [Treatment of metastatic seminoma by chemotherapy.: an experience].
  • PURPOSE: To describe the outcome of chemotherapy using cisplatin-based regimen, and experimental combination with carboplatin and ifosfamide to treat advanced seminoma.
  • 1999, 15 patients with Stage IIA, IIB, IIIA or IIIC metastatic seminoma and one patient with lung disease, who suffered a relapse of his primary mediastinal lesion were treated.
  • Three of these patients had relapsed, following surveillance for Stage I testicular cancer, and another had received prophylactic radiotherapy to the retroperitoneal lymph nodes in advance.
  • Since 1983, cases have been treated with the same regimen as that used to treat non-seminomatous germ-cell tumors; cisplatin/vinblastine/bleomycin (PVB); cisplatin/vinblastine/actinomycin D/cyclophosphamide/bleomycin (VAB-6); cisplatin/etoposide/bleomycin (BEP).
  • RESULTS: Of the entire group, 10 patients (62.5%) achieved a CR after chemotherapy alone.
  • Four cases who received radiation, following chemotherapy, produced CR.
  • CONCLUSION: As expected, the type of chemotherapy we used, to treat non-seminomatous germ-cell tumors proved to be highly effective for seminomatous types, as well.
  • Carboplatin and ifosfamide performed well and safe, in the treatment of non-bulky metastatic seminoma.
  • Comparative studies of long-term treatment results and QOL, using either radiotherapy or low-toxicity chemotherapy for Stage IIA disease should be undertaken.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Seminoma / drug therapy. Seminoma / secondary. Testicular Neoplasms / drug therapy
  • [MeSH-minor] Adult. Bleomycin / administration & dosage. Cisplatin / administration & dosage. Cyclophosphamide / administration & dosage. Dactinomycin / administration & dosage. Drug Administration Schedule. Etoposide. Humans. Ifosfamide / administration & dosage. Lung Neoplasms / secondary. Male. Mediastinal Neoplasms / drug therapy. Mediastinal Neoplasms / pathology. Middle Aged. Vinblastine / administration & dosage

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  • (PMID = 11109817.001).
  • [ISSN] 0021-5287
  • [Journal-full-title] Nihon Hinyōkika Gakkai zasshi. The japanese journal of urology
  • [ISO-abbreviation] Nippon Hinyokika Gakkai Zasshi
  • [Language] jpn
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] JAPAN
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 1CC1JFE158 / Dactinomycin; 5V9KLZ54CY / Vinblastine; 6PLQ3CP4P3 / Etoposide; 8N3DW7272P / Cyclophosphamide; Q20Q21Q62J / Cisplatin; UM20QQM95Y / Ifosfamide; BEP protocol; PVB protocol; VAB-6 regimen
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2. Yu HY, Madison RA, Setodji CM, Saigal CS: Quality of surveillance for stage I testis cancer in the community. J Clin Oncol; 2009 Sep 10;27(26):4327-32
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  • [Title] Quality of surveillance for stage I testis cancer in the community.
  • PURPOSE: Patients with clinical stage I testicular germ cell tumors have been managed with adjuvant radiotherapy, chemotherapy, or retroperitoneal lymph node dissection (RPLND).
  • The use of surveillance-only strategies at referral centers has yielded survival outcomes comparable to those achieved with adjuvant therapy.
  • We evaluated compliance with follow-up protocols developed at referral centers within the community.
  • METHODS: We identified patients with stage I testis cancer within a large private insurance claims database and calculated compliance of follow-up test use with guidelines from the National Comprehensive Cancer Network.
  • Compliance with surveillance and postadjuvant therapy follow-up testing was poor and degraded with increasing time from diagnosis.
  • Nearly 30% of all surveillance patients received no abdominal imaging, chest imaging, or tumor marker tests within the first year of diagnosis.
  • CONCLUSION: Surveillance is a widely accepted strategy in clinical stage I testicular cancer treatment in the community.
  • However, follow-up care recommendations developed at referral centers are not being adhered to in the community.
  • [MeSH-major] Neoplasms, Germ Cell and Embryonal / therapy. Population Surveillance / methods. Quality of Health Care / statistics & numerical data. Testicular Neoplasms / therapy

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  • [CommentIn] J Clin Oncol. 2009 Dec 20;27(36):e282-3; author reply e284-5 [19901125.001]
  • (PMID = 19652075.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural
  • [Publication-country] United States
  • [Other-IDs] NLM/ PMC2744273
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3. Yanada S, Ito H, Tomita M, Wada T, Hatano T, Kishimoto K, Egawa S: [A case of recurrent metastatic testicular cancer, successfully treated with paclitaxel, ifomide and cisplatin]. Hinyokika Kiyo; 2008 Jan;54(1):43-6
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  • [Title] [A case of recurrent metastatic testicular cancer, successfully treated with paclitaxel, ifomide and cisplatin].
  • A 30-year-old man was diagnosed with testicular cancer, and underwent a radical orchiectomy.
  • Pathological diagnosis was a mixed type nonseminomatous germ cell tumor.
  • We diagnosed him as having stage I testicular cancer and decided to forgo adjuvant therapy.
  • Since the serum alpha-fetoprotein (AFP) level was present at a high level at 1,297 ng/ml, he was given combination chemotherapy consisting of 3 cycles of PEB, cisplatin, etoposide and bleomycin and one cycle of PE, cisplatin and etoposide.
  • Then he was given one more cycle of VIP therapy (etoposide, ifosfamide, cisplatin), but the serum AFP level was increased to 56 ng/ml.
  • Then, two cycles of chemotherapy with paclitaxel, ifosfamide and cisplatin were administered as salvage chemotherapy, which led to a normalization of the serum AFP level, and disappearance of the brain and spleen metastases.
  • Residual lung mass was resected at the surgical department, and microscopically no viable tumor cells remained.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Neoplasms, Germ Cell and Embryonal / drug therapy. Testicular Neoplasms / drug therapy
  • [MeSH-minor] Adult. Antineoplastic Agents / administration & dosage. Antineoplastic Agents, Alkylating / administration & dosage. Antineoplastic Agents, Phytogenic / administration & dosage. Brain Neoplasms / secondary. Cisplatin / administration & dosage. Humans. Ifosfamide / administration & dosage. Lung Neoplasms / secondary. Male. Neoplasm Metastasis. Paclitaxel / administration & dosage. Salvage Therapy. Splenic Neoplasms / secondary. alpha-Fetoproteins / analysis

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  • (PMID = 18260360.001).
  • [ISSN] 0018-1994
  • [Journal-full-title] Hinyokika kiyo. Acta urologica Japonica
  • [ISO-abbreviation] Hinyokika Kiyo
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Antineoplastic Agents, Alkylating; 0 / Antineoplastic Agents, Phytogenic; 0 / alpha-Fetoproteins; P88XT4IS4D / Paclitaxel; Q20Q21Q62J / Cisplatin; UM20QQM95Y / Ifosfamide
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4. Albers P: Management of stage I testis cancer. Eur Urol; 2007 Jan;51(1):34-43; discussion 43-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Management of stage I testis cancer.
  • OBJECTIVE: Over the last 5 years the management of stage I testis cancer has changed tremendously.
  • This review focuses on the latest changes in diagnostics and treatment of clinical stage I non-seminomatous and seminomatous germ cell tumors.
  • RESULTS: Organ-sparing surgery has become an accepted approach to treat malignant and nonmalignant tumours in a solitary testis.
  • Prognostic factors strongly influence the decision for or against adjuvant treatment in seminoma and non-seminoma.
  • With the help of a risk-adapted approach, about 50% of patients with clinical stage I testis cancer will favour close surveillance instead of immediate adjuvant treatment.
  • Patients with non-seminoma with high risk for occult metastatic disease will favour adjuvant chemotherapy and in patients with seminoma radiotherapy with reduced dosage will be challenged by carboplatin monotherapy.
  • CONCLUSION: With adequate diagnostics and treatment, 100% of patients with stage I testis cancer will survive.
  • Future research will focus on quality control, adherence to guideline recommendations, and further reduction of treatment to diminish the risk of late sequalae for patients with adjuvant radiotherapy or chemotherapy.
  • [MeSH-major] Neoplasms, Germ Cell and Embryonal / therapy. Testicular Neoplasms / therapy
  • [MeSH-minor] Chemotherapy, Adjuvant. Humans. Male. Radiotherapy, Adjuvant

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  • [CommentIn] Eur Urol. 2007 Jul;52(1):295-6 [17321037.001]
  • (PMID = 16996677.001).
  • [ISSN] 0302-2838
  • [Journal-full-title] European urology
  • [ISO-abbreviation] Eur. Urol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Switzerland
  • [Number-of-references] 74
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5. Pagliaro LC: Testicular cancer: when less is more. Curr Oncol Rep; 2010 Jul;12(4):271-7
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  • [Title] Testicular cancer: when less is more.
  • Clinical stage I testicular cancer is highly curable.
  • The treatment options include adjuvant chemotherapy or surveillance for most patients, radiotherapy for seminoma, and retroperitoneal lymph node dissection for selected patients with nonseminomatous germ cell tumors.
  • This review discusses the decision points with emphasis on the advantages and disadvantages of each management option.
  • [MeSH-major] Germinoma / therapy. Seminoma / therapy. Testicular Neoplasms / therapy
  • [MeSH-minor] Chemotherapy, Adjuvant. Combined Modality Therapy. Humans. Lymph Node Excision. Male. Neoplasm Staging. Prognosis

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  • (PMID = 20443156.001).
  • [ISSN] 1534-6269
  • [Journal-full-title] Current oncology reports
  • [ISO-abbreviation] Curr Oncol Rep
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 26
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6. Stamatiou K, Papadopoulos P, Perlepes G, Galariotis N, Olympitis M, Moschouris H, Vasilakaki T: Mixed germ cell tumor of the testicle with ravdomuosarcomatous component: a case report. Cases J; 2009;2:9299

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Mixed germ cell tumor of the testicle with ravdomuosarcomatous component: a case report.
  • INTRODUCTION: Testicular tumors can be classified as seminomatous and non-seminomatous germ-cell tumor (NSGCT) types.
  • Mixed germ cell tumors contain more than one germ cell component and are much more common than any of the pure histologic forms representing 32%-60% of all germ cell tumors.
  • Here we present a rare case of a mixed germ cell tumor composed of seminoma, Yolk sack tumor and teratoma containing a sarcoma component of somatic type malignancy.
  • USG of the scrotum revealed a large right testis swelling characterized by scarce cystic elements and calcifications.
  • The patient underwent right-sided high orchidectomy and was given chemotherapy of the BEP regimen.
  • After the 2nd cycle the patient discontinued the chemotherapy and when he came for follow-up after a gap of 3 months, despite the normalisation in tumor markers values, the retroperitoneal mass was relapsed.
  • CONCLUSION: More than 50% of germ-cell tumors include more than 2 basic germ-cell tumor types, with the exception of spermatocytic seminoma.
  • About 90% of the patients with nonseminomatous tumors can achieve complete cure with aggressive chemotherapy and most of them can be cured.
  • Although prognosis of testicular tumors depends largely on clinical stage, histological type and adhesion to the treatment influence the prognosis as well.

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  • (PMID = 20062623.001).
  • [ISSN] 1757-1626
  • [Journal-full-title] Cases journal
  • [ISO-abbreviation] Cases J
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC2803963
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7. Daugaard G, Karas V, Sommer P: Inguinal metastases from testicular cancer. BJU Int; 2006 Apr;97(4):724-6
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  • [Title] Inguinal metastases from testicular cancer.
  • OBJECTIVE: To evaluate the incidence of inguinal metastases in patients with testicular cancer and relapse after initial stage I disease.
  • PATIENTS AND METHODS: Of 695 patients, 14 (2%) with stage I testicular cancer developed inguinal metastases during the follow-up on a surveillance programme.
  • At orchidectomy, one patient had involvement of the tunica albuginea and one a history of cryptorchidism and development of testicular cancer on the contralateral side.
  • The histopathological examination showed that the metastases were in lymph nodes in four patients, the remainder having a more diffuse involvement of the tissue in the inguinal region.
  • At relapse, patients were treated by three or four cycles of bleomycin, etoposide and cisplatin, except those with low-stage seminomas (stage IIa and IIb), who were treated by radiation therapy.
  • RESULTS: All patients had a complete remission after treatment with chemotherapy or radiotherapy.
  • No patients died or developed a recurrence during the median follow-up of 72 months.
  • CONCLUSION: Metastases to the inguinal region are found in approximately 2% of patients with testicular cancer; about a quarter have lymph-node metastases, the rest probably having metastases to the spermatic cord with direct invasion into the surrounding tissue.
  • Chemotherapy for patients with nonseminoma and radiotherapy for patients with seminoma gives excellent results.
  • [MeSH-major] Abdominal Neoplasms / secondary. Inguinal Canal. Neoplasms, Germ Cell and Embryonal / secondary. Testicular Neoplasms
  • [MeSH-minor] Adolescent. Adult. Follow-Up Studies. Humans. Lymph Node Excision / methods. Lymphatic Metastasis. Male. Middle Aged. Orchiectomy / methods. Seminoma / secondary. Seminoma / therapy. Treatment Outcome

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  • [CommentIn] BJU Int. 2006 Sep;98(3):690 [16925777.001]
  • (PMID = 16536762.001).
  • [ISSN] 1464-4096
  • [Journal-full-title] BJU international
  • [ISO-abbreviation] BJU Int.
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article
  • [Publication-country] England
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8. Chuang KL, Liaw CC, Ueng SH, Liao SK, Pang ST, Chang YH, Chuang HC, Chuang CK: Mixed germ cell tumor metastatic to the skin: case report and literature review. World J Surg Oncol; 2010;8:21
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  • [Title] Mixed germ cell tumor metastatic to the skin: case report and literature review.
  • BACKGROUND: Testicular cancer is the most common cancer for males aged 15 to approximately 35 years old.
  • The initial presentation is typically an asymptomatic enlarged testicle.
  • CASE PRESENTATION: A 19-year old male was diagnosed testicular mixed germ cell tumor with initial presentation of cutaneous metastasis at scalp and upper abdomen.
  • After radical orchiectomy and four courses of cisplatin-based chemotherapy, the scalp and upper abdominal lesions regressed completely.
  • CONCLUSIONS: For advanced stage testicular cancer, cisplatin-based chemotherapy is still effective to achieve partial response.
  • [MeSH-major] Neoplasms, Germ Cell and Embryonal / secondary. Orchiectomy. Skin Neoplasms / secondary. Testicular Neoplasms / pathology
  • [MeSH-minor] Adult. Combined Modality Therapy. Humans. Male. Young Adult

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  • (PMID = 20331874.001).
  • [ISSN] 1477-7819
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  • [ISO-abbreviation] World J Surg Oncol
  • [Language] eng
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9. Aparicio J, Germà JR: Treatment of stage I testicular germ-cell tumors. Med Oncol; 2006;23(3):305-15
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Treatment of stage I testicular germ-cell tumors.
  • More than a half of patients with testicular cancer are diagnosed with clinical stage I disease.
  • In this setting, definitive cure is the rule.
  • However, there is no consensus on the optimal treatment choice.
  • A literature review (1990-2005) was performed in order to identify the pros and the cons associated with each therapy, as well as their long-term outcomes.
  • Several treatment alternatives yield similar efficacy results.
  • Thus, therapy-related morbidity, economic costs, quality-of-life issues, and patient preferences should be considered.
  • Refinement in the knowledge of predictive factors for relapse and amounting experience with both surveillance and adjuvant chemotherapy have led to consideration of risk-adapted treatment policies as an alternative to more traditional approaches (i.e., prophylactic irradiation for seminomas and retroperitoneal lymph node dissection for non-seminomas).
  • In conclusion, with cure rates approaching 100%, close surveillance for low-risk patients and adjuvant chemotherapy for those at high risk of relapse seems the preferred option for clinical stage I testicular cancer, in both seminoma and non-seminoma cases.
  • [MeSH-major] Medical Oncology / methods. Neoplasms, Germ Cell and Embryonal / therapy. Testicular Neoplasms / therapy
  • [MeSH-minor] Chemotherapy, Adjuvant / methods. Humans. Lymph Node Excision. Lymph Nodes / surgery. Male. Prognosis. Radiotherapy, Adjuvant / methods. Recurrence. Risk. Seminoma / therapy. Treatment Outcome

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  • (PMID = 17018887.001).
  • [ISSN] 1559-131X
  • [Journal-full-title] Medical oncology (Northwood, London, England)
  • [ISO-abbreviation] Med. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 78
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10. Pectasides D, Pectasides E, Constantinidou A, Aravantinos G: Current management of stage I testicular non-seminomatous germ cell tumours. Crit Rev Oncol Hematol; 2009 May;70(2):114-23
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Current management of stage I testicular non-seminomatous germ cell tumours.
  • Testicular germ cell tumors represent the most common malignancies in young males between the ages of 15 and 35; 50% of those with non-seminomatous germ cell tumors (NSGCT) have clinical stage I at diagnosis.
  • Predictors for relapse include lymphovascular invasion, percentage of embryonal-cell carcinoma component, absence of yolk-sack histology and MIB1 proliferation rate.
  • Therapeutic options following orchidectomy in stage I NSGCT comprise nerve-sparing retroperitoneal lymph node dissection (RPLND), surveillance or adjuvant cisplatin-based chemotherapy.
  • Using a risk adapted approach, in about 50% of patients with clinical stage I NSGCT surveillance is favored in patients with good compliance.
  • Adjuvant chemotherapy is recommended for patients at high risk for developing metastatic disease.
  • Non-seminomatous germ cell testicular cancer is a curable neoplasia.
  • All available treatment modalities produce excellent results, with a long-term survival of almost 100%.
  • Consequently, therapy-induced toxicity is an important concern in the management of these patients.
  • An individually tailored approach that takes into account the prognostic factor profile, as well as the patients' preferences and their ability to comply with treatment, is the key for the successful management of stage I testicular cancer.
  • [MeSH-major] Neoplasms, Germ Cell and Embryonal / therapy. Testicular Neoplasms / therapy
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Chemotherapy, Adjuvant. Clinical Trials as Topic. Humans. Lymph Nodes / surgery. Male. Neoplasm Recurrence, Local. Orchiectomy. Prognosis. Risk Factors

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  • (PMID = 18805019.001).
  • [ISSN] 1879-0461
  • [Journal-full-title] Critical reviews in oncology/hematology
  • [ISO-abbreviation] Crit. Rev. Oncol. Hematol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Netherlands
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 78
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11. Pectasides D, Farmakis D, Pectasides M: The management of stage I nonseminomatous testicular germ cell tumors. Oncology; 2006;71(3-4):151-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The management of stage I nonseminomatous testicular germ cell tumors.
  • Testicular germ cell tumors represent the most common malignancies in young males; 70% of patients with seminomas and 50% of those with nonseminomatous germ cell tumors (NSGCT) have clinical stage I at diagnosis.
  • Lymphovascular invasion, embryonal-cell carcinoma component, absence of yolk sac histology and MIB1 proliferation rate represent predictors of micrometastatic diseasein stage I NSGCT.
  • Therapeutic options following orchiectomy in patients with stage I NSGCT comprise nerve-sparing retroperitoneal lymph node dissection, surveillance or adjuvant cisplatin-based chemotherapy.
  • All available treatment modalities produce excellent results, with a long-term survival of almost 100%.
  • Consequently, therapy-induced toxicity is an important concern in the management of these patients.
  • An individually tailored approach that takes into account the prognostic factor profile as well as the patient's preferences and their ability to comply with each one of the modalities is the key to the management of stage I testicular cancer.
  • [MeSH-major] Neoplasms, Germ Cell and Embryonal / therapy. Testicular Neoplasms / therapy
  • [MeSH-minor] Chemotherapy, Adjuvant. Humans. Lymph Node Excision. Male. Orchiectomy. Prognosis

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  • (PMID = 17646698.001).
  • [ISSN] 1423-0232
  • [Journal-full-title] Oncology
  • [ISO-abbreviation] Oncology
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Switzerland
  • [Number-of-references] 49
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12. de Wit R, Fizazi K: Controversies in the management of clinical stage I testis cancer. J Clin Oncol; 2006 Dec 10;24(35):5482-92
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Controversies in the management of clinical stage I testis cancer.
  • During the last two decades, definitive primary treatments and surveillance with definitive treatment deferred until relapse have demonstrated 98% to 99% cure rates in patients with stage I testis cancer, and these options have obtained firm positions in standard management.
  • The development of optimal management strategies in various countries were at least partly guided by available surgical expertise in retroperitoneal lymph node dissection in the United States, and easy access to reference hospitals in densely populated countries in Western Europe that facilitated close surveillance programs; hence, treatment preferences differ on the two sides of the Atlantic.
  • Moreover, the reduced risk of relapse resulting from the use of radiotherapy or carboplatin in stage I seminoma and of cisplatin-based chemotherapy in stage I nonseminoma must be balanced against the potential long-term adverse effects in this population of patients with a normal life expectancy.
  • [MeSH-major] Testicular Neoplasms / therapy
  • [MeSH-minor] Humans. Male. Neoplasm Recurrence, Local / pathology. Neoplasm Recurrence, Local / therapy. Neoplasm Staging. Prognosis. Randomized Controlled Trials as Topic

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  • (PMID = 17158533.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 108
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13. Gallagher DJ, Riches J, Bajorin DF: False elevation of human chorionic gonadotropin in a patient with testicular cancer. Nat Rev Urol; 2010 Apr;7(4):230-3
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] False elevation of human chorionic gonadotropin in a patient with testicular cancer.
  • BACKGROUND: A 44-year-old, HIV-positive man presented with a painless swelling of his left testicle.
  • He underwent left radical orchiectomy for a pathological stage T1 nonseminomatous germ cell tumor (NSGCT).
  • A persistently elevated postoperative human chorionic gonadotropin (hCG) level resulted in the patient being diagnosed as having low-risk, stage 1S disseminated NSGCT.
  • He was treated with four cycles of etoposide and cisplatin chemotherapy, but his hCG level had not returned to normal at the end of the treatment.
  • INVESTIGATIONS: Measurement of serum levels of tumor markers, including alpha-fetoprotein, hCG and lactate dehydrogenase, scrotal ultrasonography, HIV-1 reverse transcriptase polymerase chain reaction, CT of the thorax, abdomen and pelvis, assessment of kidney function, and measurement of follicle-stimulating hormone and luteinizing hormone levels.
  • No salvage therapy was required, and the patient remains in complete remission.
  • [MeSH-major] Biomarkers, Tumor / blood. Chorionic Gonadotropin / blood. Testicular Neoplasms / blood. Testicular Neoplasms / diagnosis
  • [MeSH-minor] Adult. Antibodies, Heterophile / adverse effects. Antineoplastic Agents / therapeutic use. False Positive Reactions. Humans. Male

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  • (PMID = 20383188.001).
  • [ISSN] 1759-4820
  • [Journal-full-title] Nature reviews. Urology
  • [ISO-abbreviation] Nat Rev Urol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antibodies, Heterophile; 0 / Antineoplastic Agents; 0 / Biomarkers, Tumor; 0 / Chorionic Gonadotropin
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14. Corvin S, Sturm W, Schlatter E, Anastasiadis A, Kuczyk M, Stenzl A: Laparoscopic retroperitoneal lymph-node dissection with the waterjet is technically feasible and safe in testis-cancer patient. J Endourol; 2005 Sep;19(7):823-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Laparoscopic retroperitoneal lymph-node dissection with the waterjet is technically feasible and safe in testis-cancer patient.
  • BACKGROUND AND PURPOSE: The acceptance of open retroperitoneal lymph node dissection (RPLND) for stage I and II nonseminomatous testicular cancer has decreased because of the intraoperative and postoperative morbidity of the procedure.
  • Laparoscopic RPLND is a minimally invasive and safe alternative for low-stage germ-cell tumors.
  • PATIENTS AND METHODS: A series of 18 patients with clinical stage I testis cancer (group A) and 7 patients who had received chemotherapy for stage II disease (group B) underwent laparoscopic RPLND at our institution.
  • The procedure was performed identically to the open approach using the modified template according to Weissbach and associates.
  • The waterjet was used for removal of lymphatic tissue from the aorta and the vena cava, as well as from the sympathetic trunk.
  • The mean operating time was 232 +/- 48 minutes.
  • The waterjet was able to remove lymphatic tissue easily and atraumatically.
  • At pressures of 20 bar, the lymph-node capsule remained completely intact, thus avoiding tumor-cell spread.
  • CONCLUSIONS: The waterjet allows the safe and complete removal of lymphatic tissue, leaving vulnerable anatomic structures intact.
  • It can decrease the learning curve of laparoscopic RPLND and contribute to better acceptance of this procedure.

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  • (PMID = 16190836.001).
  • [ISSN] 0892-7790
  • [Journal-full-title] Journal of endourology
  • [ISO-abbreviation] J. Endourol.
  • [Language] ENG
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 059QF0KO0R / Water
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15. Scholz M, Höltl W: Stage I testicular cancer. Curr Opin Urol; 2003 Nov;13(6):473-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Stage I testicular cancer.
  • PURPOSE OF REVIEW: To review current developments in the management of patients with testicular cancer, with special emphasis on risk factors for the primary tumour and treatment options for clinical stage I testicular germ cell tumours.
  • RECENT FINDINGS: The management of patients with testicular cancer has substantially improved over the past 25 years.
  • Current concepts for treating localized and regional disease have been influenced by effective systematic chemotherapy.
  • At present, cure rates approach nearly 100% for low-stage disease and more than 80% for advanced disease.
  • SUMMARY: Retroperitoneal lymph node dissection is still favoured as the therapy of choice for clinical stage I non-seminomatous germ cell tumours in many centres, but as risk factors for the primary tumour have become better understood, surveillance and risk-adapted therapy, including surveillance for low-risk patients and adjuvant chemotherapy for the high-risk group, is now being considered a therapeutic option particularly in European centres.
  • Adjuvant radiotherapy is still the gold standard for the treatment of patients with clinical stage I seminoma, but the relapse rate of 19% and a 5-year overall survival of 97.7% make surveillance a possible therapeutic option.
  • The results of phase II and III trials should soon provide additional information on carboplatin for single-agent adjuvant chemotherapy.
  • [MeSH-major] Neoplasms, Germ Cell and Embryonal / surgery. Testicular Neoplasms / surgery
  • [MeSH-minor] Chemotherapy, Adjuvant. Humans. Male. Neoplasm Staging. Prognosis. Radiotherapy, Adjuvant. Risk Factors. Survival Analysis

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  • (PMID = 14560141.001).
  • [ISSN] 0963-0643
  • [Journal-full-title] Current opinion in urology
  • [ISO-abbreviation] Curr Opin Urol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 33
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16. Beck SD, Foster RS: Long-term outcome of retroperitoneal lymph node dissection in the management of testis cancer. World J Urol; 2006 Aug;24(3):267-72
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Long-term outcome of retroperitoneal lymph node dissection in the management of testis cancer.
  • In low volume testicular 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 nerve-sparring surgery.
  • The optimal treatment for low stage disease is largely patient driven with surgery and surveillance considered the primary treatment modalities.
  • In the post chemotherapy population, patients with complete radiographic resolution of retroperitoneal disease are observed at Indiana University as the relapse rate in this population is approximately 5%.
  • Residual masses after chemotherapy should be resected.
  • A modified post chemotherapy dissection is adequate in low volume disease restricted to the primary landing zone of the affected testicle.
  • In chemo-refractory disease, aggressive surgery provides a 5 year survival of 31% for patients with active cancer.
  • [MeSH-major] Lymph Node Excision. Testicular Neoplasms / surgery
  • [MeSH-minor] Combined Modality Therapy. Humans. Male. Neoplasm Staging. Retroperitoneal Space. Treatment Outcome

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  • (PMID = 16523338.001).
  • [ISSN] 0724-4983
  • [Journal-full-title] World journal of urology
  • [ISO-abbreviation] World J Urol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Germany
  • [Number-of-references] 39
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17. Yoon GH, Stein JP, Skinner DG: Retroperitoneal lymph node dissection in the treatment of low-stage nonseminomatous germ cell tumors of the testicle. Expert Rev Anticancer Ther; 2005 Feb;5(1):75-85
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Retroperitoneal lymph node dissection in the treatment of low-stage nonseminomatous germ cell tumors of the testicle.
  • Nonseminomatous germ cell tumors of the testicle are highly treatable and curable.
  • The evolution of cancer control for this disease has demonstrated an effective integration of medical and surgical approaches over the last 30 years.
  • Current emphasis in the therapy of nonseminomatous germ cell tumors focuses on minimizing treatment-related morbidity while maintaining consistently high cure rates.
  • Retroperitoneal lymph node dissection in experienced hands is a critical component of the treatment armamentarium in this disease.
  • Retroperitoneal lymph node dissection is an accurate staging tool that provides important information in determining the need for chemotherapy.
  • Retroperitoneal lymph node dissection alone can also provide high cure rates in patients with clinical low-stage disease and high-risk factors such as lymphovascular invasion or predominance of embryonal histology in the primary tumor.
  • Teratoma is known to be chemoresistant and, when present in the primary tumor of low-stage patients, may be best treated with primary retroperitoneal lymph node dissection.
  • Primary chemotherapy in the treatment of low-stage nonseminomatous germ cell tumors deserves continual investigation as long-term toxicities become more apparent.
  • [MeSH-major] Lymph Node Excision / methods. Neoplasms, Germ Cell and Embryonal / surgery. Testicular Neoplasms / surgery
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Humans. Laparoscopy. Male. Neoplasm Staging. Prognosis. Retroperitoneal Space. Risk Factors

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  • (PMID = 15757440.001).
  • [ISSN] 1744-8328
  • [Journal-full-title] Expert review of anticancer therapy
  • [ISO-abbreviation] Expert Rev Anticancer Ther
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Number-of-references] 59
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18. Yoon GH, Stein JP, Skinner DG: Retroperitoneal lymph node dissection in the treatment of low-stage nonseminomatous germ cell tumors of the testicle: an update. Urol Oncol; 2005 May-Jun;23(3):168-77
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  • [Title] Retroperitoneal lymph node dissection in the treatment of low-stage nonseminomatous germ cell tumors of the testicle: an update.
  • Nonseminomatous germ cell tumors (NSGCT) of the testicle are highly treatable and curable.
  • The evolution of cancer control for this disease has shown an effective integration of medical and surgical approaches over the last 3 decades.
  • Current emphasis in the therapy of NSGCT focuses on minimizing treatment-related morbidity while maintaining consistently high cure rates as previously seen.
  • Retroperitoneal lymph node dissection (RPLND) in experienced hands is a critical component of the treatment armamentarium in this disease.
  • RPLND is an accurate staging tool providing important information to determine the need for chemotherapy.
  • RPLND alone can also provide high cure rates in patients with low clinical stage disease and high risk factors, such as lymphovascular invasion or predominance of embryonal histology in the primary tumor.
  • Teratoma is chemoresistant and, when present in the primary tumor of patients with low stage, may be best treated with primary RPLND.
  • Primary chemotherapy in the treatment of low stage NSGCT deserves continual investigation as long-term toxicities become more apparent.
  • [MeSH-major] Lymph Node Excision. Neoplasm Staging / methods. Neoplasms, Germ Cell and Embryonal / pathology. Neoplasms, Germ Cell and Embryonal / surgery. Testicular Neoplasms / pathology. Testicular Neoplasms / surgery

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  • (PMID = 15907716.001).
  • [ISSN] 1078-1439
  • [Journal-full-title] Urologic oncology
  • [ISO-abbreviation] Urol. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 57
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19. Bauduceau O, Souleau B, Le-Moulec S, Houlgatte A, Bernard O: [Radiotherapy in stage I testicular seminoma: retrospective study and review of literature]. Cancer Radiother; 2003 Dec;7(6):386-94
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  • [Title] [Radiotherapy in stage I testicular seminoma: retrospective study and review of literature].
  • [Transliterated title] Radiothérapie des séminomes testiculaires de stade I : étude rétrospective et revue de la littérature.
  • INTRODUCTION: Seminoma accounts for about 40% of germ cell tumours of the testicle.
  • In this retrospective analysis, we review literature concerning management of stage I seminoma.
  • MATERIALS AND METHODS: Between March 1987 and April 2001, 65 patients with stage I pure testicular seminoma received adjuvant radiotherapy with a 25 MV linear accelerator.
  • Testicular tumour has been found on the right testis in 39 patients and on the left one in 24 patients.
  • Patients have been treated using an anterior-posterior parallel pair and have received 20-25 Gy in 10-14 fractions.
  • Median follow-up time was 37 months.
  • DISCUSSION: Because of good radio-sensitivity of seminoma, radiotherapy is regarded as standard adjuvant treatment (5 years relapse rate: 3-5%).
  • Secondary neoplasia represents one of the worst possible long-term complications of therapy.
  • Waiting for ongoing randomised trials, the modern literature for seminoma reflects a trend toward lower radiation doses (20-25 Gy) and smaller treatment volumes (paraaortic field).
  • Adjuvant chemotherapy with two courses of carboplatin, might be equivalent to radiotherapy but must be investigated in randomised trials.
  • [MeSH-major] Seminoma / radiotherapy. Testicular Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Antineoplastic Agents / administration & dosage. Antineoplastic Agents / therapeutic use. Carboplatin / administration & dosage. Carboplatin / therapeutic use. Chemotherapy, Adjuvant. Combined Modality Therapy. Dose Fractionation. Follow-Up Studies. Humans. Lymphatic Metastasis. Male. Middle Aged. Neoplasm Metastasis. Neoplasm Recurrence, Local. Orchiectomy. Prognosis. Radiotherapy Dosage. Radiotherapy, Adjuvant. Retrospective Studies. Testis / pathology. Time Factors

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  • (PMID = 14725912.001).
  • [ISSN] 1278-3218
  • [Journal-full-title] Cancer radiothérapie : journal de la Société française de radiothérapie oncologique
  • [ISO-abbreviation] Cancer Radiother
  • [Language] fre
  • [Publication-type] Comparative Study; English Abstract; Journal Article
  • [Publication-country] France
  • [Chemical-registry-number] 0 / Antineoplastic Agents; BG3F62OND5 / Carboplatin
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20. Géczi L, Gomez F, Bak M, Bodrogi I: The incidence, prognosis, clinical and histological characteristics, treatment, and outcome of patients with bilateral germ cell testicular cancer in Hungary. J Cancer Res Clin Oncol; 2003 May;129(5):309-15
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  • [Title] The incidence, prognosis, clinical and histological characteristics, treatment, and outcome of patients with bilateral germ cell testicular cancer in Hungary.
  • PURPOSE: To examine the incidence, prognosis, clinical and histological characteristics, treatment, and outcome of patients with bilateral testicular cancer in the referral center in Hungary, to determine which parameters might predict a second testicular tumor. METHODS: .
  • Clinical parameters-such as time of original surgery, histology of primary tumor, extent of the disease, serum marker concentrations, history of testicular abnormalities, treatment, response to treatment, follow-up period, data on second carcinoma-of bilateral testicular tumors among the 2,386 patients with testicular cancer treated between November 1988 and November 1998 were analyzed.
  • RESULTS: The incidence of patients with synchronous testicular tumor was 0.8% (19 of 2,386 patients).
  • Median follow-up time was 93 months and the 5-year overall survival was 84%.
  • The incidence of patients with metachronous testicular cancer (median age 28 years and 35 years at first and second tumor diagnosis) was 2.2% (53 of 2,386 patients) and the median time to second tumor was 76 months (range 18-203 months).
  • The clinical stages at the first and second tumor diagnosis were: 14 I/A, 21 I/B, 15 II/A, 2 II/B, and 1 III/B, and 26 I/A, 16 I/B, 3 II/A, 1 II/B, 7 III/B, respectively.
  • The median follow-up time was 42 months and the 5-year overall survival was 93%.
  • In thirteen patients with metachronous cancers, two family histories of testicular cancer, five cases of undescended testicles, seven cases of testicular atrophy, and one case of azoospermia were detected.
  • There was a non-significant trend to a longer cancer interval after chemotherapy and radiotherapy and a tendency to a greater incidence of asynchronous seminoma after chemotherapy.
  • Clinical stage I tumors were more frequent in the surveyed group than among patients not followed up according to the institutional protocol ( P = 0.01), but the survival rate was good in both groups.
  • Seminoma as a second tumor was diagnosed in an older age group (median 38 years, range 25-49 years) than nonseminoma (median 32 years, range 21-51 years, P < 0.045).
  • The interval till the appearance of a metachronous testicular cancer depended on tumor histology: in seminoma cases it was longer than in nonseminoma cases (median time: 121 months versus 50 months, P = 0.002).
  • CONCLUSIONS: The overall incidence of bilateral testicular cancer in the referral center in Hungary was 3%.
  • We could not identify clinical factors which predicted a higher risk for metachronous testicular cancer.
  • With regular follow-up the early diagnosis of second testicular tumors is probable; therefore education, self-examination of the remaining testicle, and long-term follow-up are important in early detection.
  • [MeSH-major] Germinoma. Neoplasms, Second Primary. Testicular Neoplasms
  • [MeSH-minor] Adult. Biomarkers, Tumor / blood. Chemotherapy, Adjuvant. Chorionic Gonadotropin, beta Subunit, Human / blood. Humans. Hungary / epidemiology. Incidence. Male. Middle Aged. Neoplasm Staging. Orchiectomy. Prognosis. Radiotherapy, Adjuvant. Risk Factors. Self-Examination. Seminoma / blood. Seminoma / epidemiology. Seminoma / pathology. Seminoma / therapy. Survival Analysis. Treatment Outcome. alpha-Fetoproteins / metabolism

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  • (PMID = 12748851.001).
  • [ISSN] 0171-5216
  • [Journal-full-title] Journal of cancer research and clinical oncology
  • [ISO-abbreviation] J. Cancer Res. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Chorionic Gonadotropin, beta Subunit, Human; 0 / alpha-Fetoproteins
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21. Lagrange JL, Ramaioli A, Theodore CH, Terrier-Lacombe MJ, Beckendorf V, Biron P, Chevreau CH, Chinet-Charrot P, Dumont J, Delobel-Deroide A, D'Anjou J, Chassagne C, Parache RM, Karsenty JM, Mercier J, Droz JP, Radiation Therapy Group and the Genito-Urinary Group of the French Federation of Cancer Centres: Non-Hodgkin's lymphoma of the testis: a retrospective study of 84 patients treated in the French anticancer centres. Ann Oncol; 2001 Sep;12(9):1313-9
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  • [Title] Non-Hodgkin's lymphoma of the testis: a retrospective study of 84 patients treated in the French anticancer centres.
  • Primary non-Hodgkin's lymphoma of the testicle is rare.
  • Diffuse large B-cell lymphoma was diagnosed in 75% of cases.
  • Treatment included orchidectomy and radiotherapy and/or chemotherapy.
  • A complete response was obtained in 72.6% of the patient population and in 100%, 68% and 33% of stage I, II and III-IV disease respectively.
  • Recurrence occurred in 32 cases and the most frequent site was the central nervous system: six of these patients presented stage I disease.
  • Median overall survival was 32 months for the entire population, 52 months for stage I, 32 months for stage II, and 12 months for stage III-IV cases (P < 0.0001).
  • Among patients presenting stage I disease, no difference was found between those treated with combined surgery and chemotherapy or surgery followed or not followed by radiotherapy.
  • This study confirms that non-Hodgkin's lymphoma of the testicle carries a poor prognosis.
  • Systemic adjuvant chemotherapy should be discussed because of the high recurrence rate.

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  • (PMID = 11697846.001).
  • [ISSN] 0923-7534
  • [Journal-full-title] Annals of oncology : official journal of the European Society for Medical Oncology
  • [ISO-abbreviation] Ann. Oncol.
  • [Language] ENG
  • [Publication-type] Journal Article
  • [Publication-country] England
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22. Sheinfeld J, Motzer RJ: Stage I testicular cancer management and necessity for surgical expertise. J Clin Oncol; 2008 Jun 20;26(18):2934-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Stage I testicular cancer management and necessity for surgical expertise.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Testicular Neoplasms / drug therapy. Testicular Neoplasms / surgery
  • [MeSH-minor] Bleomycin / administration & dosage. Cisplatin / administration & dosage. Combined Modality Therapy. Etoposide / administration & dosage. Humans. Male. Neoplasm Staging. Neoplasms, Germ Cell and Embryonal

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  • [CommentOn] J Clin Oncol. 2008 Jun 20;26(18):2966-72 [18458040.001]
  • (PMID = 18458042.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Comment; Editorial
  • [Publication-country] United States
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin
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