Hodentumoren aus klinischer Sicht

TY - JOUR

T1 - Hodentumoren aus klinischer Sicht

T2 - Was Urolog:Innen und Onkolog:Innen von Patholog:Innen über Hodentumoren wissen müssen

AU - Oing, Christoph

AU - Fankhauser, Christian Daniel

N1 - © 2022. The Author(s).

PY - 2022/11

Y1 - 2022/11

N2 - BACKGROUND: Testicular germ cell tumours (GCTs) are the most frequent solid malignancy in younger males aged 15-40. The differentiation between seminomas and non-seminomas impacts prognosis, clinical management and follow-up procedures. With stage- and risk-adapted multimodal treatment approaches, GCTs have an exceptionally good prognosis. Therefore, avoiding overtreatment to reduce treatment-related long-term side effects is of utmost importance. Clinical and histopathological risk factors aid in treatment decision-making.OBJECTIVES: Discussion of (histo-)pathological characteristics that directly influence treatment decision-making by urologists and oncologists.MATERIALS AND METHODS: Non-systematic literature review to describe histopathological features for interdisciplinary treatment planning.RESULTS: Key histopathological characteristics for clinicians are: (i) identification of a GCT, if necessary by 12p aberration analysis, (ii) description of the different subtypes, and (iii) risk factors, including lymphovascular invasion and/or rete testis infiltration and size of the primary tumour. Molecular pathological analyses, that is, genomic sequencing, is not part of routine diagnostics due to the lack of prognostic/predictive markers and effective targeted treatment approaches.DISCUSSION: Detailed histopathology reporting, ideally with a synoptic template, is the basis for planning and conducting guideline-endorsed, risk-adapted, multi-disciplinary management of GCTs. Along with radiographic imaging and assessment of the serum tumour markers AFP and β‑HCG (especially in non-seminomas), histopathology is crucial to maintain success and reduce the burden of GCT treatment.

AB - BACKGROUND: Testicular germ cell tumours (GCTs) are the most frequent solid malignancy in younger males aged 15-40. The differentiation between seminomas and non-seminomas impacts prognosis, clinical management and follow-up procedures. With stage- and risk-adapted multimodal treatment approaches, GCTs have an exceptionally good prognosis. Therefore, avoiding overtreatment to reduce treatment-related long-term side effects is of utmost importance. Clinical and histopathological risk factors aid in treatment decision-making.OBJECTIVES: Discussion of (histo-)pathological characteristics that directly influence treatment decision-making by urologists and oncologists.MATERIALS AND METHODS: Non-systematic literature review to describe histopathological features for interdisciplinary treatment planning.RESULTS: Key histopathological characteristics for clinicians are: (i) identification of a GCT, if necessary by 12p aberration analysis, (ii) description of the different subtypes, and (iii) risk factors, including lymphovascular invasion and/or rete testis infiltration and size of the primary tumour. Molecular pathological analyses, that is, genomic sequencing, is not part of routine diagnostics due to the lack of prognostic/predictive markers and effective targeted treatment approaches.DISCUSSION: Detailed histopathology reporting, ideally with a synoptic template, is the basis for planning and conducting guideline-endorsed, risk-adapted, multi-disciplinary management of GCTs. Along with radiographic imaging and assessment of the serum tumour markers AFP and β‑HCG (especially in non-seminomas), histopathology is crucial to maintain success and reduce the burden of GCT treatment.

U2 - 10.1007/s00292-022-01113-0

DO - 10.1007/s00292-022-01113-0

M3 - SCORING: Review

C2 - 36156132

VL - 43

SP - 434

EP - 440

JO - PATHOLOGIE

JF - PATHOLOGIE

SN - 2731-7188

IS - 6

ER -