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Metastatic surgery in testis cancer
David Pfister1, Friederike Haidl, Pia Paffenholz
1Department of Urology, University Hospital Cologne, Cologne, Germany.
Current Opinion in Urology
|July 9, 2016
Summary
Testis cancer treatment, even with metastases, has an excellent prognosis. This review highlights current guideline recommendations for managing patients with multiple metastatic deposits, emphasizing multidisciplinary care and specialized centers.
Area of Science:
- Oncology
- Surgical Oncology
- Medical Guidelines
Background:
- Testis cancer generally has an excellent prognosis, even in cases of metastatic disease.
- Managing patients with multiple metastatic deposits presents treatment and timing challenges.
Purpose of the Study:
- To review and underline current guideline recommendations for testis cancer treatment.
- To provide clarity on managing complex metastatic cases.
Main Methods:
- Review of current guideline recommendations for testis cancer management.
- Analysis of treatment strategies based on primary histology and metastatic site.
Main Results:
- Surgical resection indications vary by primary histology (seminoma vs. nonseminoma).
- Fluorodeoxyglucose-PET (FDG-PET) guides residual tumor resection in seminoma; repeat PET advised for critical results.
- Post-chemotherapy retroperitoneal lymph node dissection is indicated for nonseminoma patients not in complete remission.
- Resection of bone, liver, and pulmonary metastases is recommended based on histology and location.
- Brain metastases are rare with no standard treatment.
Conclusions:
- Multidisciplinary tumor board presentation is crucial for all patients.
- Surgical interventions should be performed in tertiary referral centers for optimal outcomes and reduced morbidity.
