Aktuelle Therapie organbegrenzter Hodentumoren

Zusammenfassung

Hintergrund: In Deutschland entfallen ca. 1–2% aller bösartigen Tumoren auf testikuläre Keimzelltumoren. Es handelt sich somit zwar um einen seltenen Tumor, dennoch nimmt er in mehrerlei Hinsicht eine Sonderrolle ein. In der Gruppe der 20- bis 35-jährigen Männer ist er der häufigste bösartige Tumor. Dadurch sind ganz unmittelbar die Familienplanung und der Lebensentwurf des jungen Mannes gefährdet, die gerade in diesem Alter eine bedeutende Rolle spielen. Eine weitere Besonderheit bösartiger Hodentumore besteht in der exzellenten Heilungsrate seit der Einführung platinhaltiger Chemotherapie-Regimes. Dadurch hat sich zuletzt der Fokus der medizinisch-therapeutischen Innovationen hin zur Therapiereduktion verschoben, zumal die Therapie über die akute Toxizität hinaus schwerwiegende Langzeitfolgen bis hin zur Induktion eines Sekundärmalignoms bedingen kann.

Ziel der Arbeit: Der vorliegende Artikel fasst den aktuellen therapeutischen Standard der malignen Hodentumoren im klinischen Stadium I zusammen.

Material und Methoden: Selektive Literaturrecherche in PubMed

Ergebnisse und Diskussion: Neben möglichen Implikationen für eine organerhaltende operative Therapie werden der Nutzen risikoadaptierter Vorgehensweisen sowie Möglichkeiten zur Anwendung einer Surveillance-Strategie bei lokalisierten Hodentumoren erläutert.

Abstract

Background: In Germany, testicular cancer accounts for about 1–2% of all malignant tumours. Although, therefore, this is a rare tumour, it assumes an exceptional position among malignant tumours in several respects. In male patients aged 20–35 years it is the most common tumour, which directly affects the family and life planning of young men, a matter of prime importance at this age. Another aspect of testicular cancer is its excellent prognosis since the introduction of platinum-based chemotherapy into the armamentarium of testicular cancer therapy. Therefore, therapeutic innovations increasingly focus on reducing the radicality of treatment, even more so since this therapy, in addition to acute toxicity, can cause severe long-term consequences up to and including secondary malignancies.

Objectives: This article gives an overview of the present therapeutic standard of stage I testicular cancer treatment.

Material and Methods: Selective PubMed research

Results and Discussion: Besides potential implications for organ-sparing surgery, the article elucidates the benefits of a risk-adapted therapeutic approach and indications for a surveillance strategy for patients with localised testicular cancer.

Schlüsselwörter

Seminom - Nicht-Seminom - Organerhalt - Surveillance - Therapiereduktion

Key words

seminoma - non-seminoma - organ-sparing - surveillance - therapy reduction

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