Management of Germ Cell Tumours of the Testis in Adult Patients. German Clinical Practice Guideline Part I: Epidemiology, Classification, Diagnosis, Prognosis, Fertility Preservation, and Treatment Recommendations for Localized Stages.

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Tytuł:: Management of Germ Cell Tumours of the Testis in Adult Patients. German Clinical Practice Guideline Part I: Epidemiology, Classification, Diagnosis, Prognosis, Fertility Preservation, and Treatment Recommendations for Localized Stages.
Autorzy:: Kliesch S; Centre of Reproductive Medicine and Andrology, Department of Clinical and Surgical Andrology, University Hospital Münster, Münster, Germany, .
Schmidt S; für Urologie, Berlin, Germany.
Wilborn D; für Urologie, Berlin, Germany.
Aigner C; Ruhrlandklinik at University Hospital Essen, Essen, Germany.
Albrecht W; Department of Urology, Landesklinikum Mistelbach-Gänserndorf, Mistelbach, Austria.
Bedke J; Department of Urology, University Hospital Tübingen, Tübingen, Germany.
Beintker M; Südharz Hospital Nordhausen gGmbH, Nordhausen, Germany.
Beyersdorff D; Clinic and Polyclinic for Diagnostic and Interventional Radiology and Nuclear Medicine, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
Bokemeyer C; II. Medical Clinic and Polyclinic, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
Busch J; Department of Urology, Charité University Hospital, Berlin, Germany.
Classen J; Department of Radiotherapy, Radiological Oncology and Palliative Medicine, St. Vincentius-Kliniken, Karlsruhe, Germany.
de Wit M; Clinic for Internal Medicine - Hematology, Oncology and Palliative Medicine, Vivantes Clinic Neukölln, Berlin, Germany.
Dieckmann KP; Department of Urology, Asklepios Klinik Altona, Hamburg, Germany.
Diemer T; Clinic and Polyclinic for Urology, Pediatric Urology and Andrology, University Hospital Gießen, Gießen, Germany.
Dieing A; Clinic for Internal Medicine - Hematology and Oncology, Vivantes Clinics Am Urban, Berlin, Germany.
Gockel M; HELIOS Clinics Berlin-Buch, Berlin, Germany.
Göckel-Beining B; Urologist, Horn-Bad Meinberg, Germany.
Hakenberg OW; Urological Clinic and Polyclinic, University Hospital Rostock, Rostock, Germany.
Heidenreich A; Department of Urology, University Hospital Cologne, Cologne, Germany.
Heinzelbecker J; Department of Urology, University Hospital Saarland, Saarbrücken, Germany.
Herkommer K; Urological Clinic and Polyclinic of the Technical University of Munich, Munich, Germany.
Hermanns T; Department of Urology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Kaufmann S; Department for Radiooncology, University Hospital Tübingen, Tübingen, Germany.
Kornmann M; Clinic for General and Visceral Surgery, University Hospital Ulm, Ulm, Germany.
Kotzerke J; Klinik und Poliklinik für Nuklearmedizin, University Hospital Dresden, Dresden, Germany.
Krege S; KEM, Protestant Hospital Essen-Mitte, Clinic for Urology, Pediatric Urology and Urological Oncology, Essen, Germany.
Kristiansen G; Institute of Pathology, University Hospital Bonn, Bonn, Germany.
Lorch A; Department of Urology, University Hospital Düsseldorf, Düsseldorf, Germany.
Müller AC; Department for Radiooncology, University Hospital Tübingen, Tübingen, Germany.
Oechsle K; II. Medical Clinic and Polyclinic, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
Ohloff T; Advisor, German Foundation for Young Adults with Cancer, Berlin, Germany.
Oing C; II. Medical Clinic and Polyclinic, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
Otto U; Urological Competence Centre for Rehabilitation, Bad Wildungen, Germany.
Pfister D; Department of Urology, University Hospital Cologne, Cologne, Germany.
Pichler R; Department of Urology, Medical University Innsbruck, Innsbruck, Austria.
Recken H; HFH, Hamburger Fern-Hochschule Studienzentrum Essen (Distance Learning University, Essen Study Centre), Essen, Germany.
Rick O; Klinik Reinhardshöhe GmbH, Bad Wildungen, Germany.
Rudolph Y; German Cancer Society, Berlin, Germany.
Ruf C; Department of Urology, Bundeswehrkrankenhaus (German Federal Armed Forces Hospital), Ulm, Germany.
Schirren J; Helios Clinics, Wiesbaden, Germany.
Schmelz H; Department of Urology, Bundeswehrkrankenhaus (German Federal Armed Forces Hospital), Koblenz, Germany.
Schmidberger H; Clinic and Polyclinic for Radiooncology and Radiotherapy, University Hospital Mainz, Mainz, Germany.
Schrader M; Helios Clinics, Berlin, Germany.
Schweyer S; Clinic for Pathology, Starnberg, Germany.
Seeling S; University of Osnabrück, Campus Lingen, Osnabrück, Germany.
Souchon R; Department for Radiooncology, University Hospital Tübingen, Tübingen, Germany.
Winter C; Urologie Neandertal (Regional Joint Practice), Erkrath, Germany.
Wittekind C; Institute of Pathology, University Hospital Leipzig, Leipzig, Germany.
Zengerling F; Department of Urology, University Hospital Ulm, Ulm, Germany.
Zermann DH; Vogtland-Klinik Bad Elster, Bad Elster, Germany.
Zillmann R; Urology Pankow, Berlin, Germany.
Albers P; Department of Urology, University Hospital Düsseldorf, Düsseldorf, Germany.
Źródło:: Urologia internationalis [Urol Int] 2021; Vol. 105 (3-4), pp. 169-180. Date of Electronic Publication: 2021 Jan 07.
Typ publikacji:: Journal Article; Review
Język:: English
Imprint Name(s):: Publication: Basel : Karger
Original Publication: Basel.
MeSH Terms:: Neoplasms, Germ Cell and Embryonal*/classification
Neoplasms, Germ Cell and Embryonal*/diagnosis
Neoplasms, Germ Cell and Embryonal*/epidemiology
Neoplasms, Germ Cell and Embryonal*/therapy
Testicular Neoplasms*/classification
Testicular Neoplasms*/diagnosis
Testicular Neoplasms*/epidemiology
Testicular Neoplasms*/therapy
Adult ; Fertility Preservation ; Humans ; Male ; Neoplasm Staging ; Practice Guidelines as Topic ; Prognosis
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Contributed Indexing:: Keywords: Clinical practice guideline; Diagnosis; Fertility preservation; Germ cell tumour of the testis; Prognosis; Staging
Entry Date(s):: Date Created: 20210107 Date Completed: 20210722 Latest Revision: 20210722
Update Code:: 20240105
PubMed Central ID:: PMC8006579
DOI:: 10.1159/000510407
PMID:: 33412555
: Czasopismo naukowe

Introduction: This is the first German evidence- and consensus-based clinical guideline on diagnosis, treatment, and follow-up on germ cell tumours (GCTs) of the testis in adult patients. We present the guideline content in two publications. Part I covers the topic's background, methods, epidemiology, classification systems, diagnostics, prognosis, and treatment recommendations for the localized stages.
Methods: An interdisciplinary panel of 42 experts including 1 patient representative developed the guideline content. Clinical recommendations and statements were based on scientific evidence and expert consensus. For this purpose, evidence tables for several review questions, which were based on systematic literature searches (last search was in March 2018) were provided. Thirty-one experts entitled to vote, rated the final clinical recommendations and statements.
Results: We provide 161 clinical recommendations and statements. We present information on the quality of cancer care and epidemiology and give recommendations for staging and classification as well as for diagnostic procedures. The diagnostic recommendations encompass measures for assessing the primary tumour as well as procedures for the detection of metastases. One chapter addresses prognostic factors. In part I, we separately present the treatment recommendations for germ cell neoplasia in situ, and the organ-confined stages (clinical stage I) of both seminoma and nonseminoma.
Conclusion: Although GCT is a rare tumour entity with excellent survival rates for the localized stages, its management requires an interdisciplinary approach, including several clinical experts. Quality of care is highly related to institutional expertise and can be reassured by established online-based second-opinion boards. There are very few studies on diagnostics with good level of evidence. Treatment of metastatic GCTs must be tailored to the risk according to the International Germ Cell Cancer Collaboration Group classification after careful diagnostic evaluation. An interdisciplinary approach as well as the referral of selected patients to centres with proven experience can help achieve favourable clinical outcomes.
(© 2021 The Author(s). Published by S. Karger AG, Basel.)

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