Salvage management of patients with relapsing testicular germ cell tumors

Purpose of review This review aims to summarize the latest evidence of medical and surgical treatment options for patients with relapsing testicular germ cell tumors. Recent findings Depending on International Germ Cell Cancer Classification Group risk classification 10–50% of patients with metastatic TGCT develop relapse which needs further multimodality treatment. With regard to therapy, early relapses are stratified according to their prognostic risk profile which results in a 3-year overall survival between 6% in the very high to 77% in the very low risk group. Prognostic risk score dictates systemic therapy which might be second line chemotherapy (TIP, PEI) or high dose chemotherapy. Any residual masses following salvage chemotherapy need to be completely resected due the presence of viable cancer and/or teratoma in more than 50% of cases. Targeted therapy in men with druggable mutations is for individualized cases only. Patients with late relapses developing more than 2 years after first-line chemotherapy are best managed by surgery. Desperation surgery is reserved for those patients with rising markers during or immediately after chemotherapy and good risk factors such as rising alpha-fetoprotein,
Source: Current Opinion in Urology - Category: Urology & Nephrology Tags: SALVAGE THERAPY IN UROLOGY ONCOLOGY: Edited by R. Jeffrey Karnes and Axel Heidenreich Source Type: research