Guía clínica sobre el cáncer de testículo de la EAU

TY - JOUR

T1 - Guía clínica sobre el cáncer de testículo de la EAU

T2 - actualización de 2011

AU - Albers, P

AU - Albrecht, W

AU - Algaba, F

AU - Bokemeyer, C

AU - Cohn-Cedermark, G

AU - Fizazi, K

AU - Horwich, A

AU - Laguna, M P

AU - European Association of Urology

N1 - Copyright © 2011 AEU. Published by Elsevier Espana. All rights reserved.

PY - 2012/3/1

Y1 - 2012/3/1

N2 - CONTEXT: On behalf of the European Association of Urology (EAU), guidelines for the diagnosis, therapy, and follow-up of testicular cancer were established.OBJECTIVE: This article is a short version of the EAU testicular cancer guidelines and summarises the main conclusions from the guidelines on the management of testicular cancer.EVIDENCE ACQUISITION: Guidelines were compiled by a multidisciplinary guidelines working group. A systematic review was carried out using Medline and Embase, also taking Cochrane evidence and data from the European Germ Cell Cancer Consensus Group into consideration. A panel of experts weighted the references, and a level of evidence and grade of recommendation were assigned.RESULTS: There is a paucity of literature especially regarding longer term follow-up, and results from a number of ongoing trials are awaited. The choice of treatment centre is of the utmost importance, and treatment in reference centres within clinical trials, especially for poor-prognosis nonseminomatous germ cell tumours, provides better outcomes. For patients with clinical stage I seminoma, based on recently published data on long-term toxicity, adjuvant radiotherapy is no longer recommended as first-line adjuvant treatment. The TNM classification 2009 is recommended.CONCLUSIONS: These guidelines contain information for the standardised management of patients with testicular cancer based on the latest scientific insights. Cure rates are generally excellent, but because testicular cancer mainly affects men in their third or fourth decade of life, treatment effects on fertility require careful counselling of patients, and treatment must be tailored taking individual circumstances and patient preferences into account.TAKE HOME MESSAGE: Although testicular cancer has excellent cure rates, the choice of treatment centre is of the utmost importance. Expert centres achieve better results for both early stage testicular cancer (lower relapse rates) and overall survival (higher stages within clinical trials). For patients with clinical stage I seminoma, adjuvant radiotherapy is no longer recommended as first-line adjuvant treatment.

AB - CONTEXT: On behalf of the European Association of Urology (EAU), guidelines for the diagnosis, therapy, and follow-up of testicular cancer were established.OBJECTIVE: This article is a short version of the EAU testicular cancer guidelines and summarises the main conclusions from the guidelines on the management of testicular cancer.EVIDENCE ACQUISITION: Guidelines were compiled by a multidisciplinary guidelines working group. A systematic review was carried out using Medline and Embase, also taking Cochrane evidence and data from the European Germ Cell Cancer Consensus Group into consideration. A panel of experts weighted the references, and a level of evidence and grade of recommendation were assigned.RESULTS: There is a paucity of literature especially regarding longer term follow-up, and results from a number of ongoing trials are awaited. The choice of treatment centre is of the utmost importance, and treatment in reference centres within clinical trials, especially for poor-prognosis nonseminomatous germ cell tumours, provides better outcomes. For patients with clinical stage I seminoma, based on recently published data on long-term toxicity, adjuvant radiotherapy is no longer recommended as first-line adjuvant treatment. The TNM classification 2009 is recommended.CONCLUSIONS: These guidelines contain information for the standardised management of patients with testicular cancer based on the latest scientific insights. Cure rates are generally excellent, but because testicular cancer mainly affects men in their third or fourth decade of life, treatment effects on fertility require careful counselling of patients, and treatment must be tailored taking individual circumstances and patient preferences into account.TAKE HOME MESSAGE: Although testicular cancer has excellent cure rates, the choice of treatment centre is of the utmost importance. Expert centres achieve better results for both early stage testicular cancer (lower relapse rates) and overall survival (higher stages within clinical trials). For patients with clinical stage I seminoma, adjuvant radiotherapy is no longer recommended as first-line adjuvant treatment.

KW - Algorithms

KW - Antineoplastic Combined Chemotherapy Protocols

KW - Cancer Care Facilities

KW - Chemotherapy, Adjuvant

KW - Combined Modality Therapy

KW - Diagnostic Imaging

KW - Disease Management

KW - Evidence-Based Medicine

KW - Humans

KW - Lymph Node Excision

KW - Male

KW - Neoplasm Staging

KW - Neoplasms, Germ Cell and Embryonal

KW - Orchiectomy

KW - Organ Sparing Treatments

KW - Prognosis

KW - Radiotherapy, Adjuvant

KW - Salvage Therapy

KW - Sex Cord-Gonadal Stromal Tumors

KW - Societies, Medical

KW - Testicular Neoplasms

KW - Treatment Outcome

KW - Tumor Markers, Biological

U2 - 10.1016/j.acuro.2011.06.017

DO - 10.1016/j.acuro.2011.06.017

M3 - SCORING: Zeitschriftenaufsatz

C2 - 22188753

VL - 36

SP - 127

EP - 145

JO - ACTAS UROL ESP

JF - ACTAS UROL ESP

SN - 0210-4806

IS - 3

ER -