Zusammenfassung
Die Mehrzahl der Männer mit metastasiertem Hodenkrebs wird durch eine primäre Chemotherapie geheilt. Selten spricht jedoch die Erkrankung auf die primäre Behandlung ungenügend an oder tritt nach zunächst erfolgreicher Behandlung zu einem späteren Zeitpunkt erneut auf. Die dann erforderliche Salvage-Therapie kann bei vielen Betroffenen immer noch zu einer dauerhaften Heilung der Erkrankung führen. Allerdings ist die Salvage-Therapie komplizierter und nebenwirkungsreicher als die primäre Behandlung und sollte ausschließlich an Einrichtungen durchgeführt werden, die sich auf die Therapie dieser Patienten spezialisiert haben.
Literatur
Albers P, Dommer K, Muller SC (1998) Hodentumoren. Todesfälle und Rezidive nach inadäquater Therapie. Urologe A 37:625–628
Albers P, Ganz A, Hannig E et al (2000) Salvage surgery of chemorefractory germ cell tumors with elevated tumor markers. J Urol 164:381–384
André F, Fizazi K, Culine S, Droz JP, Taupin P, Lhommé C, Terrier-Lacombe MJ, Théodore C (2000) The growing teratoma syndrome: results of therapy and long-term follow-up of 33 patients. Eur J Cancer 36:1389–1394
Beck SDW, Foster RS, Bihrle R, Einhorn LH, Donohue JP (2005) Outcome analysis for patients with elevated serum tumor markers at postchemotherapy retroperitoneal lymph node dissection. J Clin Oncol 23:6149–6156
Beyer J, Albers P, Altena R (2013) Maintaining success, reducing treatment burden, focusing on survivorship: highlights from the third European consensus conference on diagnosis and treatment of germ-cell cancer. Ann Oncol 24:878–888
Donadio AC, Motzer RJ, Bajorin DF, Kantoff PW, Sheinfeld J, Houldsworth J, Chaganti RSK, Bosl GJ (2003) Chemotherapy for teratoma with malignant transformation. J Clin Oncol 21:4285–4291
Einhorn LH, Williams SD, Chamness A, Brames MJ, Perkins SM, Abonour R (2007) High-dose chemotherapy and stem-cell rescue for metastatic germ-cell tumors. N Engl J Med 357:340–348
Fankhauser CD, Honecker F, Beyer J, Bode PK (2015) Emerging therapeutic targets for male germ cell tumors. Curr Oncol Rep 17:54
Farhat F, Culine S, Theodore C, Bekradda M, Terrier-Lacombe MJ, Droz JP (1996) Cisplatin and ifosfamide with either vinblastine or etoposide as salvage therapy for refractory or relapsing germ cell tumor patients. Cancer 77:1193–1197
Feldman D, Lorch A, Kramar A (2016) Brain metastases in patients with germ cell tumors: prognostic factors and treatment options – An analysis from the global germ cell cancer group. J Clin Oncol 34:345–351
George DW, Foster RS, Hromas RA, Robertson KA, Vance GH, Ulbright TM, Gobbett TA, Heiber DJ, Heerema NA, Ramsey HC, Thurston VC, Jung S-H, Shen J, Finch DE, Kelley MR, Einhorn LH (2003) Update on late relapse of germ cell tumor: a clinical and molecular analysis. J Clin Oncol 21:113–122
Hartmann J, Schmoll HJ, Kuczyk MA, Candelaria M, Bokemeyer C (1997) Postchemotherapy resections of residual masses from metastatic non-seminomatous testicular germ cell tumors. Ann Oncol 8:531–538
Heidenreich A, Krege S, Flaßhove M (2004) Interdisziplinäre Kooperation in der Therapie von komplexen Patienten mit fortgeschrittenem testikulärem Keimzelltumor. Urol A 43:1521–1530
Heidenreich A, Ohlmann CH, Hegele A, Beyer J (2005) Repeat retroperitoneal lymphadenectomy in advanced testicular cancer. Eur Urol 47:64–71
Hendry WF, Norman AR, Dearnaley DP, Fisher C, Nicholls J, Huddart RA, Horwich A (2002) Metastatic nonseminomatous germ cell tumors of the testis: results of elective and salvage surgery for patients with residual retroperitoneal masses. Cancer 94:1668–1676
Horwich A, Shipley J, Huddart R (2006) Testicular germ-cell cancer. Lancet 367:754–765
International Prognostic Factor Study Group (2010) Prognostic factors in patients with metastatic germ cell tumors who experienced treatment failure with cisplatin-based first-line chemotherapy. J Clin Oncol 28(33):4906–4911
Kondagunta GV, Bacik J, Donadio A, Bajorin D, Marionv S, Sheinfeld J, Bosl GJ, Motzer RJ (2005) Combination of paclitaxel, ifosfamide, and cisplatin is an effective second-line therapy for patients with relapsed testicular germ cell tumors. J Clin Oncol 23:6549–6555
Kuczyk MA, Bokemeyer C, Kollmannsberger C, Corvin C, Anastasias S, Machtens S, Merseburger A, Wegener G, Stenzel A, Hartmann JT, Jonas U (2004) Late relapse after treatment for nonseminomatous germ cell tumors according to a single center-based experience. World J Urol 22:55–59
Loehrer PJ, Gonin R, Nichols CR, Weathers T, Einhorn LH (1998) Vinblastine plus ifosfamide plus cisplatin as initial salvage therapy in recurrent germ cell tumor. J Clin Oncol 16:2500–2504
Lorch A, Kollmannsberger C, Hartmann JT, Metzner B, Schmidt-Wolf IGH, Berdel BE, Weissinger F, Schleicher J, Egerer G, Haas A, Schirren R, Beyer J, Bokemeyer C, Rick O (2007) Single versus sequential high-dose chemotherapy in patients with relapsed or refractory germ cell tumors: a prospective randomized multicenter trial of the German Testicular Cancer Study Group. J Clin Oncol 25:2778–2784
Lorch A, Neubauer A, Hackenthal M et al (2009) High-dose chemotherapy (HDCT) as second-salvage treatment in patients with multiple relapsed or refractory germ-cell tumors. Ann Oncol 21:820–825
Lorch A, Bascoul-Mollevi C, Kramar A et al (2011) Conventional-Dose versus high-dose chemotherapy as first salvage treatment in male patients with metastatic germ cell tumors: evidence from a large international database. J Clin Oncol 29(16):2178–2184
Lutke Holzik MF, Hoekstra HJ, Mulder NH, Suurmeijer AJH, Sleijfer DT, Gietema JA (2003) Non–germ cell malignancy in residual or recurrent mass after chemotherapy for nonseminomatous testicular germ cell tumor. Ann Surg Oncol 10:131–135
Miller KD, Loehrer PJ, Gonin R, Einhorn LH (1997) Salvage chemotherapy with vinblastine, ifosfamide, and cisplatin in recurrent seminoma. J Clin Oncol 15:1427–1431
Motzer RJ, Mazumdar M, Sheinfeld J, Bajorin DF, Macapinlac HA, Bains M, Reich L, Flombaum C, Mariani T, Tong WP, Bosl GJ (2000) Sequential dose-intensive paclitaxel, ifosfamide, carboplatin and etoposide salvage therapy for germ cell tumor patients. J Clin Oncol 18:1173–1180
Murphy BR, Breeden ES, Donohue JP, Messemer J, Walsh W, Roth BJ, Einhorn LH (1993) Surgical salvage of chemorefractory germ cell tumors. J Clin Oncol 11:324–329
Pico JL, Rosti G, Kramar A, Wandt H, Koza V, Salvioni R, Theodore C, Lelli G, Siegert W, Horwich A, Marangolo M, Linkesch W, Pizzocaro G, Schmoll HJ, Bouzy J, Droz JP, Biron P (2005) A randomized trial of high-dose chemotherapy in the salvage treatment of patients failing first-line platinum chemotherapy for advanced germ cell tumors. Ann Oncol 16:1152–1159
Porcu P, Bhatia S, Sharma M, Einhorn LH (2000) Results of treatment after relapse from high-dose chemotherapy in germ cell tumors. J Clin Oncol 18:1181–1186
Rick O, Bokemeyer C, Weinknecht S, Schirren J, Pottek T, Hartmann JT, Braun T, Rachud B, Weißbach L, Hartmann M, Siegert W, Beyer J (2004) Residual tumor resection after high-dose chemotherapy in patients with relapsed or refractory germ cell cancer. J Clin Oncol 22:3713–3719
Saxman SB, Nichols CR, Einhorn LH (1994) Salvage chemotherapy in patients with extragonadal nonseminomatous germ cell tumors: the Indiana University experience. J Clin Oncol 12:1390–1393
Shahidi M, Norman A, Nicholls J, Dearnaley D, Horwich A, Huddart R (2002) Late recurrence in 1263 men with testicular germ cell tumours: multivariate analysis of risk factors and implications for management. Cancer 95:520–530
Sharp DS, Carver BS, Eggener SE, Kondagunta GV, Motzer RJ, Bosl GJ, Sheinfeld J (2008) Clinical outcome and predictors of survival in late relapse of germ cell tumor. J Clin Oncol 26:5524–5529
Sonneveld DJ, Sleijfer DT, Koops HS, Keemers-Gels ME, Molenaar WM, Hoekstra HJ (1998) Mature teratoma identified after postchemotherapy surgery in patients with disseminated nonseminomatous testicular germ cell tumors: a plea for an aggressive surgical approach. Cancer 82:1343–1351
Stenning SP, Parkinson MC, Fisher C, Mead GM, Cook PA, Fosså SD, Horwich A, Jones WG, Newlands ES, Oliver RT, Stenwig AE, Wilkinson PM (1998) Postchemotherapy residual masses in germ cell tumor patients: content, clinical features, and prognosis. Medical Research Council Testicular Tumour Working Party. Cancer 83:1409–1419
Vaena DA, Abonour R, Einhorn LH (2003) Long-term survival after high-dose salvage-chemotherapy for germ cell malignancies with adverse prognostic variables. J Clin Oncol 21:4100–4104
Vuky J, Tickoo SK, Sheinfeld J, Bacik J, Amsterdam A, Mazumdar M, Reuter V, Bajorin DF, Bosl GJ, Motzer RJ (2002) Salvage chemotherapy for patients with advanced pure seminoma. J Clin Oncol 20:297–301
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer-Verlag GmbH Deutschland, ein Teil von Springer Nature
About this entry
Cite this entry
Beyer, J., Heidenreich, A., Schuler, M., Meiler, J. (2019). Refraktäre Hodentumore und Rezidive: Therapie. In: Rübben, H., Hakenberg, O., Grimm, MO., Burger, M. (eds) Uroonkologie. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-54652-9_70-1
Download citation
DOI: https://doi.org/10.1007/978-3-662-54652-9_70-1
Received:
Accepted:
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-662-54652-9
Online ISBN: 978-3-662-54652-9
eBook Packages: Springer Referenz Medizin