Current Management of Disseminated Germ Cell Tumors - 03/07/19

Doi : 10.1016/j.ucl.2019.04.003

Jean-Michel Lavoie, MD, FRCPC ^a, Christian K. Kollmannsberger, MD, FRCPC ^b,^⁎
^a Genitourinary Service, Division of Medical Oncology, Department of Medicine, BC Cancer- Vancouver Cancer Center, University of British Columbia, 600 West 10th Avenue, Vancouver, British Columbia V5Z 4E6, Canada
^b Division of Medical Oncology, Department of Medicine, BC Cancer--Vancouver Cancer Center, University of British Columbia, 600 West 10th Avenue, Vancouver, British Columbia V5Z 4E6, Canada

^∗Corresponding author.

Résumé

The modern treatment of disseminated germ cell tumors (GCT) relies largely on cisplatin-based regimens, particularly combination chemotherapy with bleomycin, etoposide, and cisplatin. This article reviews the evidence supporting its use as well as common alterations based on prognostic grouping or contraindications to bleomycin. Special topics around the management of intermediate/poor prognosis choriocarcinoma and brain metastases are included. The management of residual masses for both seminoma and nonseminoma is discussed as well as long-term follow-up care of patients. Finally, the management of relapsed disseminated GCT is addressed.

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Keywords : Testis cancer, Management guidelines, Chemotherapy, Disseminated germ cell tumor