ISSN:
1569-8041
Schlagwort(e):
carcinoma in situ
;
chemotherapy
;
testicular cancer
Quelle:
Springer Online Journal Archives 1860-2000
Thema:
Medizin
Notizen:
Abstract Background: Approximately 5% of patients with testicular cancerharbour carcinoma in situ (CIS) in the contralateral testis. CIS willprogress into invasive tumour in about 50% of cases within fiveyears. The present study evaluated the effect of platinum containingchemotherapy on CIS. Patients and methods: Thirty-three patients with disseminated germ-cellcancer and biopsy proven CIS of the testis were evaluated. Results: CIS had disappeared in the first follow-up biopsy in 30patients. Six patients had a relapse of CIS with or without invasive cancerafter 30, 31, 47, 51, 76 and 95 months from start of chemotherapy. Tworelapses were among six patients who initially received cisplatin,vinblastine and bleomycine and four among 27 patients who initially receivedcisplatin, etoposide and bleomycine. The estimated cumulative risk of CIS five and 10 years after chemotherapywas 21% and 42%, respectively. The estimated cumulativeincidence of spermatogenesis was 64% and 81% at five and 10years of follow-up, respectively. Conclusion: Platinum containing chemotherapy may eradicate CIS. However,patients with CIS may develop invasive cancer in spite of chemotherapy. In thelight of the present data, we recommend radiotherapy to the affected testiclein patients with CIS in the contralateral testis and in patients withbilateral testicular CIS. In patients with extragonadal disease and CIS in onetesticle, orchiectomy of the affected testicle is recommended. In patients forwhom future fertility is an important issue, follow-up including repeatedbiopsies can be offered for a period of at least 10 years.
Materialart:
Digitale Medien
URL:
http://dx.doi.org/10.1023/A:1008213515649
