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Multimodale Therapie des Hodentumors: wann Chemotherapie, Operation oder Strahlentherapie?

Multimodal treatment of testicular cancer: chemotherapy, surgery or radiotherapy?

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Zusammenfassung

Hintergrund

Um optimale Therapieergebnisse zu erzielen sind metastasierte Hodentumorpatienten auf eine histologie- und stadienadaptierte Therapie angewiesen.

Ziel der Arbeit

Diese Arbeit fokussiert auf eine interdisziplinäre Darstellung der aktuellen Therapieempfehlungen für metastasierte Hodentumorpatienten.

Material und Methoden

Basierend auf der deutschen S3-Leitlinie sowie ergänzend um aktuelle Literatur wurden die interdisziplinären Empfehlungen formuliert.

Ergebnisse

Nur eine stadiengerechte, leitlinienbasierte Therapie, die ein interdisziplinäres Zusammenwirken zwischen Urologie, Onkologie und Strahlentherapie erfordert, führt zu exzellenten Heilungschancen. Besonders herausfordernd bleibt die Frage nach der „optimalen Therapie“ des Seminoms im cSII A/B.

Schlussfolgerung

Da die Therapie fortgeschrittener oder rezidivierender Hodentumorpatienten komplex bleibt, wird explizit auf die Möglichkeit einer Online-Zweitmeinung verwiesen (https://urologie.ekonsil.org).

Abstract

Background

Metastatic testicular germ cell tumors patients require histology- and stage-appropriate therapy to achieve optimal therapeutic outcomes.

Objectives

This work focuses on the interdisciplinary presentation of current recommendations for the treatment of metastatic germ cell tumor patients.

Materials and methods

The interdisciplinary recommendations were formulated based on the German S3 guideline and supplemented by recent literature.

Results

Using a stage-specific and guideline-based treatment approach, interdisciplinary cooperation between urology, oncology, and radiotherapy is mandatory to successfully achieve a high rate of cure and, in the case of complex advanced tumors, also the most effective therapy possible. The question of optimal treatment approaches for seminoma in cSII A/B remains particularly challenging.

Conclusion

Since treatment of advanced or multiple relapsed germ cell tumor patients remains complex, patients should be referred for an online second opinion (https://urologie.ekonsil.org).

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Authors and Affiliations

  1. Klinik für Urologie, Bundeswehrzentralkrankenhaus Koblenz, Rübenacherstraße 170, 56072, Koblenz, Deutschland

    Tim Nestler FEBU & Hans Schmelz

  2. Klinik für Radioonkologie und Strahlentherapie, RKH Kliniken Ludwigsburg-Bietigheim, Ludwigsburg, Deutschland

    Arndt-Christian Müller

  3. Klinik Onkologie, Hämatologie und Stammzelltransplantation mit Abteilung für Pneumologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland

    Christoph Seidel

Authors
  1. Tim Nestler FEBU
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  2. Hans Schmelz
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  4. Christoph Seidel
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Corresponding author

Correspondence to Tim Nestler FEBU.

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Interessenkonflikt

T. Nestler, H. Schmelz, A.-C. Müller und C. Seidel geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Nestler, T., Schmelz, H., Müller, AC. et al. Multimodale Therapie des Hodentumors: wann Chemotherapie, Operation oder Strahlentherapie?. Urologie 61, 1315–1323 (2022). https://doi.org/10.1007/s00120-022-01953-x

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  • DOI: https://doi.org/10.1007/s00120-022-01953-x

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