Testicular seminoma and non-seminoma: ESMO-EURACAN Clinical Practice Guideline for diagnosis, treatment and follow-up

Oldenburg, Jan; Berney, Daniel M.; Bokemeyer, Carsten; Climent, Miguel Ángel; Daugaard, Gedske; Gietema, Jourik A.; Giorgi, Ugo De; Haugnes, Hege Sagstuen; Huddart, Robert; Leão, Ricardo; Sohaib, Aslam; Gillessen, Silke; Powles, Thomas

doi:10.1016/j.annonc.2022.01.002

Cited by 80 publications

(93 citation statements)

References 99 publications

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“…Testicular cancer is relatively rare, but it is the most commonly diagnosed malignancy in males aged 20 to 39 years [ 157 ]. Germ cell tumors account for 95% of testicular cancer and they are categorized into seminomas and non-seminomas [ 158 ]. Non-seminomas, which include embryonal carcinoma, choriocarcinoma, yolk sac tumors, and teratoma, are clinically and biologically aggressive, whereas seminomas usually have an indolent clinical course [ 158 ].…”

Section: Nir-pit For Urologic Cancersmentioning

confidence: 99%

“…Germ cell tumors account for 95% of testicular cancer and they are categorized into seminomas and non-seminomas [ 158 ]. Non-seminomas, which include embryonal carcinoma, choriocarcinoma, yolk sac tumors, and teratoma, are clinically and biologically aggressive, whereas seminomas usually have an indolent clinical course [ 158 ]. Patients suspected of testicular cancer undergo high inguinal orchiectomy for diagnostic and therapeutic purposes.…”

Section: Nir-pit For Urologic Cancersmentioning

confidence: 99%

“…Patients suspected of testicular cancer undergo high inguinal orchiectomy for diagnostic and therapeutic purposes. After the pathological diagnosis of germ cell tumors, therapeutic strategies are determined based on tumor stage and whether it is seminomatous or non-seminomatous [ 158 ].…”

Section: Nir-pit For Urologic Cancersmentioning

confidence: 99%

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Near-Infrared Photoimmunotherapy (NIR-PIT) in Urologic Cancers

Fukushima

Türkbey

Pinto

et al. 2022

Cancers

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Near-infrared photoimmunotherapy (NIR-PIT) is a novel molecularly-targeted therapy that selectively kills cancer cells by systemically injecting an antibody-photoabsorber conjugate (APC) that binds to cancer cells, followed by the application of NIR light that drives photochemical transformations of the APC. APCs are synthesized by selecting a monoclonal antibody that binds to a receptor on a cancer cell and conjugating it to IRDye700DX silica-phthalocyanine dye. Approximately 24 h after APC administration, NIR light is delivered to the tumor, resulting in nearly-immediate necrotic cell death of cancer cells while causing no harm to normal tissues. In addition, NIR-PIT induces a strong immunologic effect, activating anti-cancer immunity that can be further boosted when combined with either immune checkpoint inhibitors or immune suppressive cell-targeted (e.g., regulatory T cells) NIR-PIT. Currently, a global phase III study of NIR-PIT in recurrent head and neck squamous cell carcinoma is ongoing. The first APC and NIR laser systems were approved for clinical use in September 2020 in Japan. In the near future, the clinical applications of NIR-PIT will expand to other cancers, including urologic cancers. In this review, we provide an overview of NIR-PIT and its possible applications in urologic cancers.

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Section: Nir-pit For Urologic Cancersmentioning

confidence: 99%

Section: Nir-pit For Urologic Cancersmentioning

confidence: 99%

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Near-Infrared Photoimmunotherapy (NIR-PIT) in Urologic Cancers

Fukushima

Türkbey

Pinto

et al. 2022

Cancers

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“…Adjuvant chemotherapy with one course of BEP (Bleomycin, Etoposide, Cisplatin) is an alternative. In cases of stage I NSGCT with high risk, adjuvant chemotherapy ought to be discussed but surveillance can be an alternative [ 34 , 35 ].…”

Section: Follow-up and Recurrencementioning

confidence: 99%

The Role of CT in the Staging and Follow-Up of Testicular Tumors: Baseline, Recurrence and Pitfalls

Pierre

Selhane

Zareski

et al. 2022

Cancers

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Ultrasound imaging of the testis represents the standard-of-care initial imaging for the diagnosis of TGCT, whereas computed tomography (CT) plays an integral role in the initial accurate disease staging (organ-confined, regional lymph nodes, or sites of distant metastases), in monitoring the response to therapy in patients who initially present with non-confined disease, in planning surgical approaches for residual masses, in conducting follow-up surveillance and in determining the extent of recurrence in patients who relapse after treatment completion. CT imaging has also an important place in diagnosing complications of treatments. The aims of this article are to review these different roles of CT in primary TGCT and focus on different pitfalls that radiologists need to be aware of.

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“…The resection of residual, post-chemotherapy masses >1 cm in marker-negative, advanced non-seminomatous GCT (NSGCT) continues to form an important part of the treatment paradigm. Owing to the risks associated with residual teratoma or viable GCT harboured within residual masses after chemotherapy, the aggressive resection of residual disease is the recommended approach in international consensus guidelines (5)(6)(7)(8). However, post-chemotherapy retroperitoneal lymph node dissection (pcRPLND) is associated with a range of specific risks including pain, intraoperative vascular or lymphatic injury and ejaculatory dysfunction (9)(10)(11)(12).…”

Section: Introductionmentioning

confidence: 99%

A meta-analysis of clinicopathologic features that predict necrosis or fibrosis at post-chemotherapy retroperitoneal lymph node dissection in individuals receiving treatment for non-seminoma germ cell tumours

et al. 2022

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PurposePost-chemotherapy retroperitoneal lymph node dissection (pcRPLND) for residual nodal masses is a critical component of care in metastatic testicular germ cell tumour (GCT). However, the procedure is not of therapeutic value in up to 50% of individuals in whom histopathology demonstrates post-treatment necrosis or fibrosis alone. Improved diagnostic tools and clinicopathologic features are needed to separate individuals who benefit from pcRPLND and avoid surgery in those who do not.MethodsA prospectively registered meta-analysis of studies reporting clinicopathologic features associated with teratoma, GCT and/or necrosis/fibrosis at pcRPLND for metastatic non-seminoma GCT (NSGCT) was undertaken. We examined the effect of various clinicopathologic factors on the finding of necrosis/fibrosis at pcRPLND. The log odds ratios (ORs) of each association were pooled using random-effects models.ResultsUsing the initial search strategy, 4,178 potentially eligible abstracts were identified. We included studies providing OR relating to clinicopathologic factors predicting pcRPLND histopathology, or where individual patient-level data were available to permit the calculation of OR. A total of 31 studies evaluating pcRPLND histopathology in 3,390 patients were eligible for inclusion, including two identified through hand-searching the reference lists of eligible studies. The following were associated with the presence of necrosis/fibrosis at pcRPLND: absence of teratomatous elements in orchidectomy (OR 3.45, 95% confidence interval [CI] 2.94-4.17); presence of seminomatous elements at orchidectomy (OR 2.71, 95% CI 1.37-5.37); normal pre-chemotherapy serum bHCG (OR 1.96, 95% CI 1.62-2.36); normal AFP (OR 3.22, 95% CI 2.49–4.15); elevated LDH (OR 1.72, 95% CI 1.37-2.17); >50% change in mass during chemotherapy (OR 4.84, 95% CI 3.94-5.94); and smaller residual mass size (<2 cm versus >2 cm: OR 3.93, 95% CI 3.23-4.77; <5 cm versus >5 cm: OR 4.13, 95% CI 3.26-5.23).ConclusionsIn this meta-analysis, clinicopathologic features helped predict the presence of pcRPLND necrosis/fibrosis. Collaboration between centres that provide individual patient-level data is required to develop and validate clinical models and inform routine care to direct pcRPLND to individuals most likely to derive benefits.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42021279699

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Testicular seminoma and non-seminoma: ESMO-EURACAN Clinical Practice Guideline for diagnosis, treatment and follow-up

Cited by 80 publications

References 99 publications

Near-Infrared Photoimmunotherapy (NIR-PIT) in Urologic Cancers

Near-Infrared Photoimmunotherapy (NIR-PIT) in Urologic Cancers

The Role of CT in the Staging and Follow-Up of Testicular Tumors: Baseline, Recurrence and Pitfalls

A meta-analysis of clinicopathologic features that predict necrosis or fibrosis at post-chemotherapy retroperitoneal lymph node dissection in individuals receiving treatment for non-seminoma germ cell tumours

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