Management of Germ Cell Tumours of the Testes in Adult Patients: German Clinical Practice Guideline, PART II - Recommendations for the Treatment of Advanced, Recurrent, and Refractory Disease and Extragonadal and Sex Cord/Stromal Tumours and for the Management of Follow-Up, Toxicity, Quality of Life, Palliative Care, and Supportive Therapy

被引：20

作者：

Kliesch, Sabine ^{[1
]}

Schmidt, Stefanie ^{[2
]}

Wilborn, Doris ^{[2
]}

Aigner, Clemens ^{[3
]}

Albrecht, Walter ^{[4
]}

Bedke, Jens ^{[5
]}

Beintker, Matthias ^{[6
]}

Beyersdorff, Dirk ^{[7
]}

Bokemeyer, Carsten ^{[8
]}

Busch, Jonas ^{[9
]}

Classen, Johannes ^{[10
]}

De Wit, Maike ^{[11
]}

Dieckmann, Klaus-Peter ^{[12
]}

Diemer, Thorsten ^{[13
]}

Dieing, Anette ^{[14
]}

Gockel, Matthias ^{[15
]}

Goeckel-Beining, Bernt ^{[16
]}

Hakenberg, Oliver W. ^{[17
]}

Heidenreich, Axel ^{[18
]}

Heinzelbecker, Julia ^{[19
]}

Herkommer, Kathleen ^{[20
]}

Hermanns, Thomas ^{[21
]}

Kaufmann, Sascha ^{[22
]}

Kornmann, Marko

Kotzerke, Joerg

Krege, Susanne ^{[23
]}

Kristiansen, Glen ^{[24
]}

Lorch, Anja ^{[25
]}

Mueller, Arndt-Christian

Oechsle, Karin

Ohloff, Timur ^{[26
]}

Oing, Christoph

Otto, Ulrich ^{[27
]}

Pfister, David

Pichler, Renate ^{[28
]}

Recken, Heinrich ^{[29
]}

Rick, Oliver ^{[30
]}

Rudolph, Yvonne ^{[31
]}

Ruf, Christian ^{[32
]}

Schirren, Joachim ^{[33
]}

Schmelz, Hans ^{[34
]}

Schmidberger, Heinz ^{[35
]}

Schrader, Mark ^{[36
]}

Schweyer, Stefan ^{[37
]}

Seeling, Stefanie ^{[38
]}

Souchon, Rainer

Winter, Christian ^{[39
]}

Wittekind, Christian ^{[40
]}

Zengerling, Friedemann ^{[41
]}

Zermann, D. H. ^{[42
]}

机构：

[1] Univ Hosp Munster, Dept Clin & Surg Androl, Ctr Reprod Med & Androl, Munster, Germany

[2] UroEvidence, Deutsch Gesell Urol, Berlin, Germany

[3] Univ Hosp Essen, Ruhrlandklin, Essen, Germany

[4] Landesklinikum Mistelbach Ganserndorf, Dept Urol, Mistelbach, Austria

[5] Univ Tubingen Hosp, Dept Urol, Tubingen, Germany

[6] Sudharz Hosp Nordhausen gGmbH, Nordhausen, Germany

[7] Univ Hosp Hamburg Eppendorf, Clin & Polyclin Diagnost & Intervent Radiol & Nuc, Hamburg, Germany

[8] Univ Hosp Hamburg Eppendorf, Med Clin & Polyclin 2, Hamburg, Germany

[9] Charite, Dept Urol, Berlin, Germany

[10] St Vincentius Kliniken, Dept Radiotherapy Radiol Oncol & Palliat Med, Karlsruhe, Germany

[11] Vivantes Clin Neukolln, Clin Internal Med Hematol, Berlin, Germany

[12] Asklepios Klin Altona, Dept Urol, Hamburg, Germany

[13] HELIOS Clin Berlin Buch, Berlin, Germany

[14] Urologist, Bad Meinberg, Germany

[15] Univ Hosp Rostock, Urol Clin & Polyclin, Rostock, Germany

[16] Univ Hosp Cologne, Dept Urol, Cologne, Germany

[17] Univ Hosp Saarland, Dept Urol, Saarbrucken, Germany

[18] Tech Univ Munich, Urol Clin & Polyclin, Munich, Germany

[19] Univ Zurich, Univ Zurich Hosp, Dept Urol, Zurich, Switzerland

[20] Univ Tubingen Hosp, Dept Radiooncol, Tubingen, Germany

[21] Univ Hosp Ulm, Clin Gen & Visceral Surg, Ulm, Germany

[22] Univ Hosp Dresden, Dresden, Germany

[23] Protestant Hosp Essen Mitte, KEM, Clin Urol Pediat Urol & Urol Oncol, Essen, Germany

[24] Univ Hosp Bonn, Inst Pathol, Bonn, Germany

[25] Univ Klinikum Dusseldorf, Dept Urol, Dusseldorf, Germany

[26] German Fdn Young Adults Canc, Berlin, Germany

[27] Urol Competence Ctr Rehabil, Bad Wildungen, Germany

[28] Med Univ Innsbruck, Dept Urol, Innsbruck, Austria

[29] Hamburger Fern Hsch Studienzentrum Essen, Essen, Germany

[30] Klin Reinhardshohe GmbH, Bad Wildungen, Germany

[31] German Canc Soc, Berlin, Germany

[32] Bundeswehrkrankenhaus, Dept Urol, Ulm, Germany

[33] Helios Clin, Wiesbaden, Germany

[34] Bundeswehrkrankenhaus, Dept Urol, Koblenz, Germany

[35] Univ Hosp Mainz, Clin & Polyclin Radiooncol & Radiotherapy, Mainz, Germany

[36] Helios Clin, Berlin, Germany

[37] Clin Pathol, Starnberg, Germany

[38] Univ Osnabruck, Campus Lingen, Osnabruck, Germany

[39] Urol Neandertal, Erkrath, Germany

[40] Univ Hosp Leipzig, Inst Pathol, Leipzig, Germany

[41] Univ Hosp Ulm, Dept Urol, Ulm, Germany

[42] Vogtland Klin Bad Elster, Bad Elster, Germany

[43] Urol Pankow, Berlin, Germany

来源：

UROLOGIA INTERNATIONALIS | 2021年 / 105卷 / 3-4期

关键词：

Germ cell tumour of the testes; Seminoma; Non-seminoma; Metastasis; Extragonadal tumours; Stromal tumours; Therapy; Follow-up; Toxicity; Quality of life; Palliative care; Supportive therapy; Systematic review; Guideline;

D O I：

10.1159/000511245

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Objectives: We developed the first German evidence- and consensus-based clinical guideline on diagnosis, treatment, and follow-up of germ cell tumours (GCT) of the testes in adult patients. We present the guideline content in 2 separate publications. The present second part summarizes therecommendations for the treatment of advanced disease stages and for the management of follow-up and late effects. Materials and Methods: An interdisciplinary panel of 42 experts including 1 patient representative developed the guideline content. Clinical recommendations and statements were based on scientific evidence and expert consensus. For this purpose, evidence tables for several review questions, which were based on systematic literature searches (last search in March 2018), were provided. Thirty-one experts, who were entitled to vote, rated the final clinical recommendations and statements. Results: Here we present the treatment recommendations separately for patients with metastatic seminoma and non-seminomatous GCT (stages IIA/B and IIC/III), for restaging and treatment of residual masses, and for relapsed and refractory disease stages. The recommendations also cover extragonadal and sex cord/stromal tumours, the management of follow-up and toxicity, quality-of-life aspects, palliative care, and supportive therapy. Conclusion: Physicians and other medical service providers who are involved in the diagnostics, treatment, and follow-up of GCT (all stages, outpatient and inpatient care as well as rehabilitation) are the users of the present guideline. The guideline also comprises quality indicators for measuring the implementation of the guideline recommendations in routine clinical care; these data will be presented in a future publication.

引用

页码：181 / 191

页数：11